CAJ | 학술논문

目的探讨比较改良超滤与常规超滤技术在婴幼儿先天性心脏病心内直视手术体外循环中的应用,以指导临床选择.方法选取2007年1月~2010年11月,无肝肾功能不全及其他合并症行先天性心脏病心内直视手术患儿40例,随机分为超滤组(CUF 组)20例,改良超滤(MUF)20例.分别统计比较转流前、转流结束和停机超滤结束后抽取动脉血测定血红细胞压积(Hct),术后24h 胸腔引流量,呼吸机的使用时间,术后输血量.结果所有病例无死亡,均顺利出院,术后未发现与超滤及体外循环有关的并发症.转流前的红细胞压积2组间差异无显著性(P >0.05);转流中由于两组均有一定程度的血液稀释,Hct 下降,但是 MUF 组仍高于 CUF 组(P <0.05);停机超滤结束后 MUF 组亦高于 CUF 组(P <0.05),MUF 组输入库血量、胸腔24h 引流量、呼吸机辅助时间都明显低于 CUF 组(P <0.05).结论改良超滤能较快排除体内水分,减少术后输血并缩短拔管时间,有利于改善患儿愈后.
목적탐토비교개량초려여상규초려기술재영유인선천성심장병심내직시수술체외순배중적응용,이지도림상선택.방법선취2007년1월~2010년11월,무간신공능불전급기타합병증행선천성심장병심내직시수술환인40례,수궤분위초려조(CUF 조)20례,개량초려(MUF)20례.분별통계비교전류전、전류결속화정궤초려결속후추취동맥혈측정혈홍세포압적(Hct),술후24h 흉강인류량,호흡궤적사용시간,술후수혈량.결과소유병례무사망,균순리출원,술후미발현여초려급체외순배유관적병발증.전류전적홍세포압적2조간차이무현저성(P >0.05);전류중유우량조균유일정정도적혈액희석,Hct 하강,단시 MUF 조잉고우 CUF 조(P <0.05);정궤초려결속후 MUF 조역고우 CUF 조(P <0.05),MUF 조수입고혈량、흉강24h 인류량、호흡궤보조시간도명현저우 CUF 조(P <0.05).결론개량초려능교쾌배제체내수분,감소술후수혈병축단발관시간,유리우개선환인유후.
@@@@ Objective To investigate the application of modified ultrafiltration (MUF) and conventional ul-trafiltration(CUF) during and after cardiopulmonary bypass (CPB) for pediatric open heart surgery.Methods From January 2007 to December 2010 in our hospital,40 children with congenital heart diseases undergoing operations were classified randomly into modified ultrafiltration group (MUF,n =20) and conventional ultrafiltration group (CUF,n =20).The clinical data of all the infants,including hematocrit(Hct) before CPB,intraoperative hematocrit,hematorit after CPB,volume of thoracic drainage within 24 hours after operation,mechanical ventilation support time after operation ,vol-ume of postoperative blood transfusion were observed .Results No infant was dead and no MUF-related complications occurred in our research.The difference of Hct before CPB between the 2 groups was not significant(P <0.05).Accord-ing to some degree of the blood diluted,the level of Hct was lower than before after CPB in both groups ,but compared with Hct level,MUF group was significantly higher(P <0.05).The dosage of bank blood,postoperative chest drain loss within 24 hours and ventilator time were significantly lower in MUF group (P <0.05).Conclusion MUF can filter sur-plus water efficiently,decrease blood transfusion requirement and remove the tube earlier ,which is helpful in the conva-lescence of infants.