动脉到动脉改良超滤技术在小儿心脏手术中的应用  

Application of arterial-arterial modified ultrafiltration in children undergoing extracorporeal circulation

作　　者：孙煦 朱悦倩 杨菁 姚昊[1] Sun Xu;Zhu Yueqian;Yang Jing;Yao Hao(The Second Affiliated Hospital of Nanjing Medical University,Jiangsu Nanjing 210000,China)

机构地区：[1]南京医科大学第二附属医院心外科

出　　处：《中国体外循环杂志》2019年第6期341-344,共4页Chinese Journal of Extracorporeal Circulation

摘　　要：目的比较动脉-动脉改良超滤(MUF)和动脉-静脉MUF在小儿心脏手术中的效果。方法选取2016年1月至2017年12月入住本院的68名心脏手术患儿(3个月<年龄<2岁,体重<15 kg)作为本次研究对象,将其随机分为对照组(n=33)行常规改良超滤,实验组(n=35)行动脉-动脉改良超滤。观察两组患儿在体外循环时间、停机时和改良超滤结束时的红细胞比容、体温、改良超滤时长、术后4 h红细胞悬液输注量、术后6 h心包纵膈引流量、术后呼吸机辅助时间和监护室滞留时间。结果两组在体外循环时间、改良超滤前后红细胞比容、术后呼吸机辅助时间和监护室滞留时间均无明显差异(P>0.05),但是实验组在超滤时长、超滤后体温变化、术后6 h心包纵膈引流量以及术后4 h红细胞悬液输注方面小于对照组,有明显差异(P<0.05)。结论动脉-动脉改良超滤方法可以明显缩短超滤时间和减少患儿体温变化,减少红细胞悬液的输注。Objective To compare the effects of arterial-arterial modified ultrafiltration(MUF)and arterial-venous MUF in pediatric cardiac surgery.Methods Sixty-eight children with cardiac surgery admitted to our hospital from January 2016 to December2017(age<2 years,weight<15 kg)were randomly divided into control group(n=33)for routine modified ultrafiltration and experimental group(n=35)for arterial-arterial modified ultrafiltration.Observation of the two groups of children with congenital heart disease included extracorporeal circulation time,hematocrit at the end of CPB and MUF,body temperature,duration of MUF,blood infusion volume 4 h after operation,pericardial mediastinal drainage volume 6 h after operation,postoperative ventilation time and ICU stay time.Results There was no significant difference between the two groups in the time of extracorporeal circulation,the hematocrit before and after MUF,the time of ventilator assistance after operation and the time of detention in the intensive care unit(P>0.05),but there were significant differences in the length of ultrafiltration,the change of body temperature after ultrafiltration,the pericardial mediastinal drainage volume 6 h after operation and the infusion of erythrocyte suspension 4 h after operation between the two groups(P<0.05).Conclusion Arterial-arterial MUF can significantly decrease the ultrafiltration time and body temperature changes in children,as well as postoperative red cell transfusion.

关 键 词：体外循环 改良超滤 动脉-动脉 小儿 心脏手术 

分 类 号：R47[医药卫生—护理学]