小儿体外循环的特点及管理体会

目的：为使小儿心内直视手术顺利进行，探讨其体外循(ECC)的特点。方法：对近年来施行的69例20kg以下的小儿ECC进行分析总结，了解小儿ECC的特殊性．对小儿ECC应根据小儿的自身病理生理特点确定其转流方法。结果：术后死亡6例均为法洛四联症患儿，死于术后并发症．未发生ECC意外和与其相关的并发症。结论：对小儿ECC应采用高流量灌注，应用高质量的膜肺，并注意心肌保护、酸碱平衡、电解质平衡，预充液应选择不含糖溶液．从而减轻ECC对小儿的生理干扰，促进术后恢复，减少术后并发症及死亡率。

Specialities of child extracorporeal circulation and care

Objective:The purpose of the article is to explore the specialities of child extracorporeal circulation(ECC)and so as to make open-heart surgery.Methods:Ecc of 69 children(wt<20kg)undergoing open-heart surgery in the last four years(in our hospital) were analyzed. The knowing the speciality of child Ecc and selecting the right circular way of Ecc according to child pathophysiologic specialities.Results: Postoperative death is 6 cases,which all were children with tetralogy of Fallot.They were all died of postoperative complication.They were not accidents or complication of Ecc.Conclusion:Child Ecc should select high-flow perfusion and use quality pulmotor,and pay attention to myocardial protection,acid-base balance and electrolyte balance.select the solution without glucose as prepare-liquid.These can relieve child physiolgical disturbanle form Ecc,imprve postoperative recovery andreduce postoperative complication and death rate.