不同胶体预充液对小儿体外循环术后肺功能的影响

目的探讨应用羟乙基淀粉130／0．4（万汶）、低分子右旋糖酐氨基酸注射液（利右安）对改善先天性心脏病患儿体外循环术后肺功能的影响。方法29例先天性心脏病手术患儿，随机分为三组：对照组（n=7），预充液中用乳酸林格氏液，或加入人血血浆；利右安组（n=11），预充液中加入利右安；万汶组（n=11），预充液中加入万汶。术后1h、3h和停呼吸机前测氧合指数（OI）、肺泡-动脉血氧分压差（P（A-a）O2）、氧饱和度（SaO2）、动脉血二氧化碳分压（PaCO2）。结果术后1h、3h和停呼吸机前各项肺功能指标，利右安组优于对照组，万汶组优于利右安组（P〈0．05）。结论体外循环预充液中加入非蛋白胶体代血浆有助于患儿术后早期肺功能的恢复，而万汶对术后肺功能的改善更为有益。

The Effect of Hydroxyethyl Starch(130/0.4) on Postoperative Lung Function of Congenital Heart Disease after Cardiopulmonary Bypass

OBJECTIVE To evaluate the effect of hydroxyethyl starch, dextran 40 and amino acids injection on effect of postoperative lung function of children with congenital heart disease under cardiopulmonary bypass（CPB）. METHODS 29 children undergoing CPB were randomly divided into control group（ n = 7 ）, Dextran 40 and amino acids injection group （ n = 11 ） and hydroxyethyl starch （130/0.4） group （ n = 11 ）. OI, P（A-a） O2, SaO2 and PaCO2 were measured in the trial groups at 1 hour, 3 hours postoperatively and just before stoping mechanical ventilator. RESULTS There were significant difference between the groups at every time points （ P 〈 0.05）. CONCLUSION Dextran 40 and amino and hydroxyethyl starch priming of cardioplumonary bypass improve effectively postoperative lung function of children with congenital heart disease, and hydroxyethyl starch is most efficient.