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目的探讨应用综合策略实施婴幼儿无血体外循环的可行性并对其围术期的安全性进行评价。方法自2013年11月至2014年5月共选择6~14 kg先天性心脏病患儿80名,随机分为2组,对照组(n=40)采用传统体外循环方式,实验组(n=40)实施无血体外循环策略。结果实验组患儿全部成功实施了无血体外循环,其中有33例实现了全程无血心脏手术,无严重并发症发生。围术期实验组血红蛋白浓度明显低于对照组(P<0.05),但均在安全范围;体外循环20 min时乳酸值实验组显著低于对照组(P<0.05);术后呼吸机辅助时间实验组显著短于对照组(P<0.05);24 h引流量实验组显著少于对照组(P<0.05),ICU停留时间无明显差异。结论对于体重和血红蛋白浓度合适的患儿实施无血体外循环是安全的,对患儿围术期无不良影响,且可以节约用血,可以避免库血对患儿的不良影响,更有利于患儿的康复。
Objective To explore the feasibility of using integrated strategies to implement infant bloodless cardiopulmonary bypass and to evaluate its perioperative safety. Methods Totally 80 children with congenital heart disease of 6 ~ 14 kg were selected from November 2013 to May 2014 and were randomly divided into 2 groups. The control group (n = 40) was treated by traditional cardiopulmonary bypass, while the experimental group (n = 40) Implement a bloodless cardiopulmonary bypass strategy. Results All the children in the experimental group were successfully performed bloodless cardiopulmonary bypass. Among them, 33 cases achieved complete blood-free cardiac surgery and no serious complications occurred. Perioperative hemoglobin concentration in the experimental group was significantly lower than that in the control group (P <0.05), but both were in the safe range. The lactic acid value of the experimental group was significantly lower than that of the control group at 20 min after cardiopulmonary bypass (P <0.05) The experimental group was significantly shorter than that of the control group (P <0.05). The experimental group of 24-hour drainage volume was significantly less than the control group (P <0.05), and there was no significant difference in the ICU stay time. Conclusions The blood-free extracorporeal circulation in children with proper body weight and hemoglobin concentration is safe and has no adverse effect on the perioperative period of the children, and can save the blood and avoid the adverse effects of the library blood on the children. Children’s rehabilitation.