小儿室间隔缺损修补术中不同输液方案对肺保护的作用  

Protective Effect of Different Infusion Schemes on Lung in Children Undergoing Open Heart Surgery

作　　者：刘家鹏[1] 杨进斌 韩建阁[1] LIU Jia-peng;YANG Jin-bin;HAN Jian-ge(Tianjin Chest Hospital,Tianjin Cardiovascular Diseases Institute,Tianjin,(300352),China)

机构地区：[1]天津市胸科医院麻醉科,天津市心血管病研究所,天津300352

出　　处：《中国中西医结合外科杂志》2022年第6期818-823,共6页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

基　　金：天津市卫生健康科技人才培育项目(KJ20123)。

摘　　要：目的:探讨不同输液方案对行室间隔缺损修补术患儿的肺保护作用。方法:选择2017年1月—2020年12月我院收治的行室间隔缺损修补术患儿70例,按照随机数字法分为晶体液输注组和5%白蛋白输液组,每组35例。记录不同时间点[术中切皮前(T1);出手术室前(T2);出重症监护室(T3)]动脉血气分析结果、术中出入量、体外循环时间及主动脉阻断时间、机械通气时间、重症监护室(ICU)停留时间及总住院时间。结果:5%白蛋白输注组患儿机械通气时间、ICU停留时间、输液量、红细胞使用量及失血量低于晶体液输注组,差异有统计学意义(P<0.05)。在T2、T3时,5%白蛋白输注组肺泡-动脉血氧分压差(A-aDO2)低于晶体液输注组,差异有统计学意义(P<0.05)。结论:小儿室间隔缺损修补术中应用5%白蛋白注射液能明显改善A-aDO2值,减少术中液体应用,缩短机械通气时间。Objective To investigate the pulmonary protective effect of different infusion schemes on children with ventricular septal defect(VSD)after repair.Methods 70 children who underwent ventricular septal defect repair in our hospital from January 2017 to December 2020 were randomly divided into two groups:crystalloid infusion group and 5%albumin infusion group,with 35 children in each group.Arterial blood gas analysis results,intraoperative volume,cardiopulmonary bypass time,aortic occlusion time,mechanical ventilation time,ICU stay time and total hospitalization time at different time points were recorded.Results The infusion volume and red blood cell volume of 5%albumin infusion group were lower than those of crystalloid infusion group(P<0.05);The mechanical ventilation time and ICU stay time of 5%albumin infusion group were shorter than those of crystalloid fluid infusion group(P<0.05).The level of alveolar arterial oxygen differential pressure(A-aDO2)in 5%albumin infusion group was lower than that in crystalloid infusion group at T2 and T3(P<0.05).Conclusion The application of 5%albumin injection in the repair of ventricular septal defect in children can significantly improve the value of A-aDO2,reduce the application of intraoperative fluid and shorten the time of mechanical ventilation.

关 键 词：肺泡-动脉血氧分压差 肺保护 室间隔缺损 

分 类 号：R726.1[医药卫生—儿科]