CAJ | 학술논문

　　目的探讨婴幼儿心脏手术应用全血与成分输血的利弊。方法选取60例施行体外循环心内直视手术治疗的先天性心脏病患儿，随机分为两组，分别采用输全血与成分输血（红细胞悬液结合新鲜冰冻血浆），观察对比两组术前与术后红细胞比容、胶体渗透压和动脉血气等指标，以及两组术后引流量、机械通气时间、ICU停留时间和病死率等指标，进行临床对照研究。结果输全血组用血量高于成分输血组；输全血组患儿的乳酸值在体外循环转流初期明显高于对照组（P＜0.05），其他各时点两组间无统计学差异（P＞0.05）；两组患儿术后引流量无显著性差异（P＞0.05）；机械通气时间、ICU停留时间无显著性差异（P＞0.05）；两组患儿术后均无严重并发症发生，均无院内死亡。结论应用全血与使用红细胞悬液结合新鲜冰冻血浆对婴幼儿先心病体外循环术后引流量、早期恢复无明显差异。与使用全血相比，采用红细胞悬液结合新鲜冰冻血浆，可减少婴幼儿先心病体外循环手术总用血量，达到节约用血的目的。
　　목적탐토영유인심장수술응용전혈여성분수혈적리폐。방법선취60례시행체외순배심내직시수술치료적선천성심장병환인，수궤분위량조，분별채용수전혈여성분수혈（홍세포현액결합신선빙동혈장），관찰대비량조술전여술후홍세포비용、효체삼투압화동맥혈기등지표，이급량조술후인류량、궤계통기시간、ICU정류시간화병사솔등지표，진행림상대조연구。결과수전혈조용혈량고우성분수혈조；수전혈조환인적유산치재체외순배전류초기명현고우대조조（P＜0.05），기타각시점량조간무통계학차이（P＞0.05）；량조환인술후인류량무현저성차이（P＞0.05）；궤계통기시간、ICU정류시간무현저성차이（P＞0.05）；량조환인술후균무엄중병발증발생，균무원내사망。결론응용전혈여사용홍세포현액결합신선빙동혈장대영유인선심병체외순배술후인류량、조기회복무명현차이。여사용전혈상비，채용홍세포현액결합신선빙동혈장，가감소영유인선심병체외순배수술총용혈량，체도절약용혈적목적。
Objective To explore the difference of whole blood and blood component transfusion in pediatric cardiac surgery.Methods 60 cases of children with congenital heart disease were randomly divided into two groups,who were treated with open heart surgery under cardiopulmonary bypass .Of the two groups,one was used whole blood transfusion and the other one was used blood component transfusion .Indicators such as hematocrit,colloid osmotic pressure and arterial blood gas analysis ,as well as postoperative mechanical ventilation time and ICU care duration were compared between two groups .Results The total volume of transfusion was more in the whole blood transfusion group than the components blood transfusion group .The level of lactic acid was higher in the whole blood transfusion group than the components blood transfusion group at the time of 30 min after cardiopulmonary bypassing(P <0.05),but there was no significant difference at other time points (P>0.05). There was no significant difference on the postoperative drainage volume ,the mechanical ventilation time and ICU care duration between two groups ( P >0.05).There was no severe complications and death case in both two groups.Conclusions Application of whole blood and red suspension combined with fresh frozen plasma on infants with congenital heart disease after cardiopulmonary bypass surgery ,early recovery are not significantly different . Compared with using whole blood,red suspension combined with fresh frozen plasma ,reduces the total amount of blood during cardiopulmonary bypass in infants with congenital heart disease .