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目的:本文回顾总结我院自2008年1月至2009年6月施行的100例低体重婴幼儿患者体外循环中零平衡超滤(ZBUF)与改良超滤(MUF)联合应用的经验及体会。方法:100例患儿体重多数为10 kg以下(法洛氏四联征患者体重放宽至15 kg),其中房间隔缺损患者23例,室间隔缺损患者48例,法洛氏四联征患者29例,均在低温体外循环下施行修补矫治术,转中依血色素水平适当给予零平衡超滤,停机后给予改良超滤。结果:97例患者顺利停机,3例法洛氏四联征患者出现转后低心排死亡。超滤总量为653～825 mL,其中零平衡超滤均为500 mL,停机后血色素水平为7.9～9.0 g.L-1,改良超滤后血色素水平为9.9～12.5 g.L-1,转后ICU监护时间房缺、室缺患者1～3 d,平均2.2 d,法洛氏四联征患者3～7 d,平均4.7 d。结论:零平衡超滤与改良超滤的联合应用有利于术后多余水分的排出及炎性介质的滤出,适用于小体重、血液稀释度大的婴幼儿和长时间体外循环(CPB)者。
OBJECTIVE: This review summarizes the experiences and experiences of zero balance ultrafiltration (ZBUF) and modified ultrafiltration (MUF) in 100 cases of infants with low birth weight infants undergoing cardiopulmonary bypass in our hospital from January 2008 to June 2009. Methods: The majority of 100 children with body weight below 10 kg (tetralogy of Fallot weight to 15 kg), including atrial septal defect in 23 patients, ventricular septal defect in 48 patients, tetralogy of Fallot patients 29 Cases, are under hypothermic cardiopulmonary bypass repair surgery, transfer to the appropriate hemoglobin level by zero-balance ultrafiltration, stop giving modified ultrafiltration. RESULTS: Ninety-seven patients were successfully stopped and three patients with tetralogy of Fallot had a lower cardiac output after cardiac arrest. The total amount of ultrafiltration ranged from 653 to 825 mL, with 500 mL for zero-balance ultrafiltration, 7.9-9.0 gL-1 for hemoglobin after shutdown, 9.9-12.5 gL-1 for modified ultrafiltration, Time atrial and ventricular septal defects in patients 1 ~ 3 d, an average of 2.2 d, tetralogy of Fallot patients 3 ~ 7 d, an average of 4.7 d. Conclusion: The combination of zero-balance ultrafiltration and modified ultrafiltration is beneficial to the postoperative excretion of water and filtration of inflammatory mediators. It is suitable for infants with small body weight, hemodilution and long-duration cardiopulmonary bypass (CPB) .