【摘要】 目的　研究婴幼儿体外循环 (CPB)下心脏直视手术时ACD库血预充对患者电解质、酸碱平衡及血浆白蛋白浓度的影响。方法　选择ASAⅠ -Ⅱ级先天性房间隔缺损 (ASD)、室间隔 (VSD) 32例患者 ,CPB前机器预充枸缘酸 (ACD)库血以维持患者术中红细胞比积 (Hct) 2 3～ 2 7% ,检测库血及患者转流前、转流 10min、停机前、停机后 15min及术毕时血K+ 、Na+ 、Hct、HCO3 -、Be、PCO2 、PO2 、Ca2 + 及血浆白蛋白浓度。结果　与患者转流前相比 ,转流中患者血钾浓度明显升高 (P <0 .0 5 ) ,Be值明显下降 (P <0 .0 5 ) ,血浆白蛋白浓度转流后较转流前下降 (P <0 .0 5 ) ,手术完毕时逐渐恢复正常 ,转流后ica浓度较转流前无明显变化。结论　CPB过程中预充ACD库血可升高患者血钾 ,降低血Be值 ,而ica浓度无明显变化。更多还原

【Abstract】 OBJECTIVE To study the effect of ACD reserve blood used in the hemodilution of infants cardiopulmonary bypass.METHODS 32 cases of congenital ASD and VSD (ASA status Ⅰ-Ⅱ) at the age from 1 to 3 were randomly chosen. ACD reserve blood were used in hemodilution to keep the Hct vary at the range of 0.23～0.27 in CPB.The samples drawn from ACD reserve blood and the central venous tube at the following time intervals; before CPB、10min after CPB、 before pump-off、end of operation, were measured for the levels of K +、Na +、Hct、HCO 3 -、BE、PCO 2、PO 2、Ca 2+ and albumin.RESULTS Compared with the sample taken before CPB, the concentration of K + increased significantly after CPB (P<0.05), the BE value decreased significantly after CPB(P<0.05),the concentration of albumin decreased after CPB.CONCLUSION Used ACD reserve blood can increase the blood k + and decrease the blood BE values, but no change in iCa 2+ obviously.更多还原