逆行预充术在30例体外循环心脏手术中应用的效果观察  

Study on retrograde autologous priming in 30 cases of cardiopulmonary bypass surgery

作　　者：张文斌[1] 朱成均 石泉[1] 赵振海[1] 庞宏宣[1] 唐志清[1] 

机构地区：[1]桂林医学院附属医院麻醉科,广西桂林541001

出　　处：《中国输血杂志》2015年第10期1232-1234,共3页Chinese Journal of Blood Transfusion

基　　金：广西壮族自治区卫生厅自筹经费科研课题(项目编号:Z2007213)

摘　　要：目的观察自体血逆行预充术(retrograde autologous priming,RAP)在低体重成年患者体外循环(cardiopulmonary bypass,CPB)中应用的效果及作用。方法选择首次CPB下行心脏手术的低体重(≤55kg)成年患者30例,随机分为2组:常规预充组(SP组,n=15)和自体血逆行预充组(RAP组,n=15)。RAP组患者在CPB转前进行RAP操作。记录围术期红细胞压积(hematocrit,Hct)、围术期输血率和输血量以及患者术后恢复情况。结果 2组患者一般临床资料差异无统计学意义(P>0.05)。在阻断升主动脉10 min、开放升主动脉10 min时RAP组患者HCT值明显高于SP组(P<0.05),RAP组患者围术期输血率和输血量均低于SP组(P<0.05)。结论 RAP技术用于低体重成年CPB可以避免血液的过度稀释,维持CPB术中有较高Hct值,从而达到减少围术期输血率和输血量的目的,具有较满意的节约用血作用。Objective To explore the effect of retrograde autologous priming technology （RAP） in adult eardiopulmo- nary bypass （CPB） for patients with low body weights. Methods Thirty patients with low body weights （ ≤55 kg ） were randomly selected to undergo cardiopulmonary bypass surgery and were divided into two groups： conventional priming group （ SP group, n = 15 ） and retrograde autologous priming group （ RAP group, n = 15 ）. RAP group underwent RAP operation before CPB. Perioperative hematocrit （ Hct）, the amount of blood transfused, the percentage of perioperative transfusion, and the recovery rate in the post-operative period were recorded. Results There were no statistically significant differences between the two groups of patients according to clinical data （ P 〉 0. 05 ）. During the period of aorta blockage for 10 min and the opening of ascending aorta for 10 min, patients in the RAP group had higher Hct than in SP group （ P 〈 0. 05）. The per- centage of RAP patients that underwent transfusion was lower than in SP group, in addition to receiving lower amount of transfused blood during perioperative surgeries （P 〈 0. 05 ）. Conclusion Retrograde autologous priming resulted in a signifi- cant decrease in intraoperative hemodilution and conserves the use of blood during perioperative surgeries. This technique should be considered for patients with a low body weight who are undergoing open heart surgery.

关 键 词：体外循环 自体血逆行预充 节约用血 低体重 

分 类 号：R457.1[医药卫生—治疗学] R645.1[医药卫生—临床医学]