改进型体外循环管道在婴幼儿体外循环中的应用  

Application of modified extracorporeal circulation tubes to extracorporeal circulation for infants and toddlers

作　　者：姜磊 王伟[1] 沈佳[1] 张蔚[1] 唐嘉忠 朱德明[1] 

机构地区：[1]上海交通大学医学院附属上海儿童医学中心心胸外科,上海200127

出　　处：《上海交通大学学报（医学版）》2016年第4期609-612,共4页Journal of Shanghai Jiao tong University:Medical Science

摘　　要：目的通过微小化婴幼儿体外循环(ECC)管道的长度与内径,改进改良超滤(MUF)回路,优化MUF方法,从而减少患儿在体外循环中悬浮红细胞用量,并有效改善MUF效果。方法将30例体质量小于8 kg的简单先心病患儿随机分为2组:对照组(n=15)采用传统内径为1/4英寸(0.6 cm)婴幼儿ECC管道和传统改良超滤方法(tMUF);实验组(n=15)采用改进型婴幼儿ECC管道,术后行优化改良超滤(mMUF)方法。比较2组患儿悬浮红细胞的预充量及总用血量,并且在体外循环开始前(T_1)、主动脉阻断后(T_2)、体外循环结束前(T_3)、改良超滤后(T_4)采集血液样本,检测红细胞比容(HCT)。结果实验组悬浮红细胞预充量及总用血量明显少于对照组(均P=0.001),行mMUF后HCT值上升更为显著。结论缩小ECC管道、改进MUF回路可以减少婴幼儿在先心病手术中血制品的用量并提升术毕HCT水平,达到节约用血的目的。Objective To effectively improve the effect of modified ultrafiltration （MUF） by minimizing length and diameter of extracorporeal circulation （ECC） tubes for infants and young children, improving MUF circuit, optimizing MUF method, so as to reduce the amount of suspension red blood cells used in ECC. Methods Thirty children with simple congenital heart disease with body weight 〈8 kg were randomly assigned to two groups. The control group （n =15） used traditional 1/4 inch ECG tubes and traditional modified MUF （tMUF） and the experimental group （n =15） used the modified ECG tubes and optimized and modified MUF （mMUF）. The amount of priming volume of suspension red blood cells and total amount of used blood were compared. Blood samples were collected to detect hematocrit （HCT） before EGG （Т1）, after aortic damping （Т2）, before the end of ECC （Т3）, and after MUF （Т4）. Results The amount of priming volume of suspension red blood cells and total amount of used blood in the experimental group were significandy less than those in the control group （both P =0. 001）. The HCT value increased remarkably after mMUF. Conclusion For infants and young children with congenital heart disease, reducing length and diameter of ECC tubes and improving MUF circuit can decrease the amount of blood products used during surgery and achieve the purpose of saving blood.

关 键 词：体外循环 婴幼儿 红细胞比容 改良超滤 

分 类 号：R726.5[医药卫生—儿科]