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本文探讨心内直视手术围麻醉期心钠素（ANP）的变化。 材料和方法 34例（男22,女12）先心病心内直视手术,年龄3～39岁,平均12.8±8.7岁,体重11～65kg,平均29.6±15.8kg;室缺18例,房缺6例,法乐氏四联症6例,法乐氏三联症3例,肺动脉瓣狭窄1例、心功能Ⅰ～Ⅱ级26例,Ⅲ级8例。 麻醉前用药为安定、哌替啶和东莨菪硷。不合作小儿采用肌注氯胺酮入睡,全麻诱导用安定-芬太尼-潘库溴铵,气管插管后静脉持续泵注芬太危10μg/kg,并间歇静注潘库溴铵,体外循环（CPB）前后视麻醉深浅情况吸入1～2％异氟醚维持全麻。CPB方法为浅低温停循环、无血预充法。总体外时间56.4±26.4分,主动脉阻断时间35.2±19.1分。 分别在麻醉前（T_0）、手术开始前（T_1）、CPB前（T_2）、CPB15～30min主动脉开放前（T_3）、CPB40～70min主动脉和上、下腔静脉开放后平行循环时（T_4）、术毕（T_5）、术后4小时（T_6）、术后22小时（T_7）共8个时间点从桡动脉采血,记录平均动脉压和心率,并测定T_1、T_2、T_3、T_4、T_5的中心静脉压（CVP）。分离血浆,血浆标本置于-70℃冰存,集中用放免法检测ANP。所获数据采用配对和团体t检验及相关分析处理。 结果 一、心钠素于麻醉后手术开始前较麻醉前降低（p<0.05）,手术开始后升至
This article discusses the change of atrial natriuretic peptide (ANP) during open heart surgery. Materials and methods 34 cases (male 22, female 12) open heart surgery in patients with congenital heart disease, aged 3 to 39 years, an average of 12.8 ± 8.7 years, weight 11 ~ 65kg, an average of 29.6 ± 15.8kg; 6 cases, tetralogy of Fallot in 6 cases, triptolide in 3 cases, pulmonary stenosis in 1 case, cardiac function Ⅰ ~ Ⅱ grade in 26 cases, Ⅲ grade in 8 cases. Before anesthesia medication for stability, pethidine and scopolamine. Uncooperative children with intramuscular injection of ketamine to sleep, induction of general anesthesia with stable - fentanyl - pancuronium, continuous intravenous infusion of endotracheal intubation Fenfen 10μg / kg, and intermittent intravenous pancuronium, cardiopulmonary bypass (CPB) before and after anesthesia depth of inhalation 1 ~ 2% isoflurane to maintain general anesthesia. CPB method for hypothermic circulatory arrest, no blood prefilled. Total external time 56.4 ± 26.4 points, aortic cross-clamping time 35.2 ± 19.1 points. (T_3) before CPB (T_1), before CPB (T_2), before CPA15 ~ 30min before aorta (T_3), after CPA40 ~ 70min before aorta and superior inferior vena cava were opened T_5, T_6, T_6 and T_7 were collected from the radial artery at 8 time points after operation. The mean arterial pressure and heart rate were recorded. The levels of T 1, T 2, T 3, T 4, T_5 central venous pressure (CVP). Plasma was separated and the plasma samples were stored in ice at -70 ℃. Concentration of ANP was determined by radioimmunoassay. The data obtained using paired and group t test and correlation analysis. Results First, atrial natriuretic peptide decreased before anesthesia before anesthesia (p <0.05), and then rose to