【摘要】 目的　回顾我院 37例婴幼儿先心病的体外循环 (CPB)管理 ,总结 8kg以下婴幼儿先心病外科手术中的灌注技术。方法　对我院 2 0 0 2年 12月～ 2 0 0 3年 10月的 37例 8kg以下婴幼儿先心病手术的临床资料 (年龄、性别、体重、手术类型 )及CPB情况 (CPB设备、预充液组成、CPB时间、升主动脉阻断时间等 )做一回顾性分析。结果　全组病例男性 19例 ,女性 18例。年龄 15d～ 2 0m ,体重 2 .8～ 8kg ,CPB时间 13～ 175min ,升主动脉阻断时间0～ 6 3min。全组病例均顺利脱机。 2例术后死亡。结论　婴幼儿CPB必须最大限度减少预充量 ,提供良好心肌保护和适当流量灌注 ,维持合理血球压积和胶晶比 ,使CPB整个过程趋于生理状况 ,同时采用超滤技术 ,减轻CPB后水肿 ,可有效提高手术的成功率。更多还原

【Abstract】 OBJECTIVE We reviewed the Cardiopulmonary Bypass(CPB) management of 37 infants with congenital heart diseases (CHD) to make a conclusion on the perfusion techniques in patients less than 8kg.METHODS The clinical datae ,including age,sex,body weight and operation type and CPB conditions,such as equipment,compositon of primed liquids,duration of CPB and blockage time of ascending aorta were retrospectively analyzed in 37 infants less than 8kg in body weight undergoing CHD operations from Dec,2002 to Oct 2003 in our hospital.RESULTS All the patients,including 19 boys and 18 girls,aged 15 days to 20 months and weighed 2.8 to 8kg ,The CPB duration ranged from 13 to 175 min,and the ascending aorta blockage time was 0～63 min,All the infants were successfully weared from the machine,and 2 died after opration.CONCLUSION The primed volume in infant CPB should be minimized to the greatest extent,thus to provide good myocardial protection and adequate infusion,maintain.reasonable Hct and colloid and crystalloid ration,and adapt the whole process nearer to physiological status.Meanwhile ultrafiltration should be used to minimize edema after CPB to enhance the success rate of operation.更多还原