自体血回输等综合节血措施在小儿先天性心脏病中的应用

目的 探讨自体血回输等综合节血措施在小儿先心病中的应用.方法 选取60例小儿先心病患者,随机分成实验组和对照组,每组各30例.实验组采取综合血液保护策略:自体血回输；术中应用乌司他丁和甲泼尼龙；术前3d肌注Vit K1；应用改良超滤.对照组常规操作.两组患者剩余机血均回输体内,转中监测活化凝血酶原时间(APT)值结果.同时比较两组患者间红细胞压积(HCT)、血红蛋白(Hb)、血小板(PLT)计数、异体血输入量、心包纵膈引流量、血红蛋白尿、ICU带管时间等差异.结果 与对照组相比,实验组体外循环停机后HCT、Hb、PLT数值升高,差异有统计学意义(P＜0.05)；异体血输入量、心包纵膈引流量少于对照组,差异有统计学意义(P＜0.05).结论 自体血回输等综合节血措施可以有效浓缩血液,提高机体的携氧能力和止血功能、保护血细胞、减少异体血的输入,节约用血.

Application of autohemotransfusion and other methods in the paediatric congenital heart diseases

Objective To study the application of autohemotransfusion and other methods in the paediatric congenital heart diseases.Methods Sixty cases were randomized divided into 2 groups:control group and experimental group,30 cases in each group.Comprehensive methods were taken in experimental group,including autotransfusion,application of ulinastatin and methyl-hydroprednisone,preoperative injection of vitamin K1,application of modified ultrafiltration.Surplus blood was retransfused,activitied prothrombin time(APT) was monitored.Hemoglobin(Hb),platelet(PLT),hematocrit(HCT),the volume of allogeneic blood transfusion and postoperative volume,hemoglobinuria,the time of respirator were compared between the two groups.Results There were significant differences between the two groups in postoperavtive HCT,Hb,PLT(P<0.05),and the volume of allogeneic blood transfusion and postoperavitve drainage were significantly decreased compared with control group(P<0.05).Conclusion Comprehensive mothods of blood conservation in the paediatric congenital heart diseases such as autohemotransfusion can significantly concentrate blood,protect blood,reduce the volume of blood loss during operation and allogeneic blood transfusion.