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血液稀释在小儿心内直视手术中的应用

Hemodilution during Cardiopulmonary Bypass in Children Undergoing Open Heart Surgery

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【作者】 丁伟曾因明刘海萍胡国昌

【Author】 Ding Wei, Zeng Yinming, Liu Haiping, et al Department of Anesthesiology, Affiliated Hospital of Xuzhou Medical College

【机构】 徐州医学院附属医院麻醉科

【摘要】 目的:30例小儿心内直视手术以海脉素为心肺机预充液,探讨血液稀释对小儿血球压积、血浆总蛋白、血小板及血浆电解质的影响。方法:30例分为三组,血液稀释组(HED),稀释式自身输血(HAT),输库血组(SBT),每组10例。观察三组麻醉前、心肺转流15min、回输机器余血15min、术后24h和72h血球压积、血浆总蛋白、血小板及血浆电解质变化。结果:心肺转流15minHED组和SBT组呈中度、HAT组呈中高度血液稀释。回输机器余血后,三组血球压积、血浆总蛋白均明显回升(P<0.05),血小板计数HAT组高于HED组和SBT组。血浆钾、钠、氯、钙离子浓度基本在正常范围。结论:小儿心内直视手术中采用海脉素血液稀释式自身输血是安全可行的。

【Abstract】 Objective: The effect of hemodilution on hematocrit, total plasma protein, electrolytes and blood platelet count was investigated. Methods:30 patients were divided into three groups:hemodilution (HED, n= 10),hemodilutional autotransfution (HAT, n= 10) and stored blood transfusion (SBT, n= 10). The changes of hematocrit, total plasma protein, electrolytes and blood platelet count were observed before anesthesia, at 15 min after the establishment of CPB,15 min after transfution with all primming machine blood, 24 and 72 hours after operation. Results: Moderate hemodilution was established in SBT group and moderate to profound in HED at 15 min after the establishment of CPB. After transfusion with all primming machine blood, total plasma protein and hematocrit increased remarkably ( P< 0 05). Blood platelet count was higher in HED group than that in HAT and SBT groups. Plasma K +, Na +,Cl - and Ca 2+ concentrations in all infants remained in the normal level during operation. After 24 hours, there was no significant difference in all parameters among the three groups. Conclusion: Hemodilutional autotransfusion with haemacel can be used safely in children undergoing open heart surgery.

  • 【文献出处】 临床麻醉学杂志 ,THE JOURNAL OF CLINICAL ANESTHESILOLGY , 编辑部邮箱 ,1998年06期
  • 【分类号】R726.542
  • 【被引频次】4
  • 【下载频次】22
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