论文部分内容阅读
目的将逆行自体血液预充(RAP)应用于婴儿体外循环(CPB)中,以降低婴儿围手术期异体血输入量。方法 160名婴儿先天性心脏病患者随机分为实验组和对照组,每组各80例,实验组在CPB开始前行RAP置换液量(47.1±10.9)mL,对照组不做RAP,通过计算在CPB预充液中加入异体血,维持CPB中Hct 25%。分别监测2组患儿CPB前(T1)、CPB开始15 min(T2)、CPB停止后(T3)及术后24 h的Hct、乳酸(Lac)、静脉血氧饱和度(SvO2),以及围手术期的输血量和术后24 h胸腔引流量。结果与对照组相比,实验组患儿通过RAP减少预充液量(47.1±10.9)mL,实验组Hct、Lac、SvO2在各时间点与对照组比较差异无统计学意义(P>0.05)。围手术期的异体输血量实验组(101.62±55.84)mL,对照组(123.88±56.96)mL(P<0.05),术后24 h胸腔引流量,实验组(86.42±28.26)mL、对照组(105.40±38.24)mL(P<0.05)。结论 RAP应用于婴儿CPB手术可以有效减少围手术期患儿的异体血输入量。
Objective To retrograde autologous blood prefilled (RAP) in infants with cardiopulmonary bypass (CPB), to reduce infant perioperative blood input. Methods 160 infants with congenital heart disease were randomly divided into experimental group and control group, 80 cases in each group. The experimental group received RAP replacement fluid (47.1 ± 10.9) mL before CPB, while the control group did not do RAP. Allogeneic blood was added to the CPB priming solution to maintain Hct 25% in CPB. The levels of Hct, lactate (Lac), venous oxygen saturation (SvO2) before CPB, 15 min (T2) after CPB, T3 after cessation of CPB and 24 h after operation were measured in two groups, Blood transfusion during surgery and postoperative chest drainage volume 24 h. Results Compared with the control group, the experimental group decreased the prefilled volume (47.1 ± 10.9) mL by RAP. There was no significant difference in Hct, Lac and SvO2 between the experimental group and the control group at each time point (P> 0.05) . Perioperative blood transfusion in the experimental group (101.62 ± 55.84) mL, control group (123.88 ± 56.96) mL (P <0.05), 24 h postoperative chest drainage, experimental group (86.42 ± 28.26) mL, 105.40 ± 38.24) mL (P <0.05). Conclusion The application of RAP in infant CPB can effectively reduce the amount of allogeneic blood transfusion in perioperative period.