改良超滤与零平衡超滤结合应用于婴幼儿体外循环手术59例的体会

目的总结改良超滤与零平衡超滤在59例婴幼儿体外循环手术中结合应用的经验、方法及临床效果。方法 59例婴幼儿,其中男40例,女19例,年龄4月～3岁之间,体重5～14kg,体外循环手术中均采用在体外循环过程中根据灌注压、红细胞压积给予零平衡超滤,停机后给予改良超滤。结果 59例患儿均顺利停机,无1例死亡,未出现超滤并发症,转中血球压积18～30(22.5±2)%,停机改良超滤后血球压积上升至32～38(35.8±1.4)%,在CCU住院时间为2～6d,皆顺利出院。结论在婴幼儿体外循环中将零平衡超滤与改良超滤的结合应用,零平衡超滤利于炎性介质的滤出,改良超滤可在CPB结束后快速排出多余的水分,提高红细胞压积,改善心肺功能,适用于低体重血液稀释度大的婴幼儿及体外循环时间长者。

Clinical experience of combined using of ZBUF and MUF in 59 cases of infant open heart surgery with CPB

Objective To summarize the clinical effects and the management of combined using of zero balanced ultrafiltration（ZBUF）and modified ultrafiltration（MUF）in 59 cases of infant open heart surgery with cardiopulmonary bypass（CPB）.Methods 59 patients diagnosed as congenital heart disease had been involved,which included 40 males and 19 females with 10±2.5 months of age and 9.0±4.1kg of weight.ZBUF was done during CPB and MUF was performed aftrr CPB.The variety of hematocrit（HCT） and mean arterial pressure（MAP） were measured during ultrafiltration.Results All patients recovered unevenfully without any severe complications.HCT of patients rised to 35.8±1.4% after MUF from 22.5±2% during CPB.Conclusion Cobined using of ZBUF and MUF has the effective ability of removing the inflammatory mediaters,while can improve the respiratory and heart function through decreasing the body water and increasing hematocrit.