应用抑肽酶和糖皮质激素体外循环术后白细胞总数的动态变化

目的观察体外循环术后白细胞总数动态变化。方法2005年1月～2005年8月我院的先天性心脏病、室间隔缺损患者50例,男30例,女20例,年龄(12±10)岁。手术由同一组医师完成,体外循环时间(40±15)min,常规心房切口修补室间隔缺损,转流期间应用地塞米松10mg,抑肽酶42000U/kg。术后1、3、5、7d分别抽取外周血2ml进行血常规检查并记录数据,另外常规拍胸部正位片,尿常规检查,切口换药。其中有10例并发切口感染及肺部感染。把所有病例分为感染组和非感染组。结果非感染组内白细胞总数之间差别有统计学意义,白细胞总数逐渐下降。两组间第1天白细胞总数差别无统计学意义,第3、5、7d差别有统计学意义,感染组明显高于非感染组。结论体外循环术后白细胞总数早期明显升高,以后逐浙下降,大约7d降至正常范围;如果7d后白细胞总数仍然较高,可能是有感染性并发症。

The change of the count of white blood cells after the cardiacpulmonary by-pass with aprotinin and dexmethasone

Objective To investigate the change of the count of the white blood cells(WBC) after the cardiopulmonary bypass(CPB). Methods Total 50 patients with the congential heart、ventricular sepeal defect(VSD) received operation in our hospital from Jan.2005～Aug.2005,which were conducted by the same couple of surgeons,including 30 male patients,20 female patients,the mean age was (12±10) years old.The CPB was conventionally conducted,normothermic blood cardioplegia was delivered antegrade via the aortic root.The mean time of the cross-clamping was almost (40±15) min.During CPB, dexmethasone 10mg and aprotinin 42000U/kg were added into the blood circulation.All post-operation patients were devided into two groups, one was infections and the other one was non-infections by the X-ray graphy of the chest,urine routine test and the observation on the wound.The infectious were 10 and the other were 40.All post-operation patients were as taken down respectively on first day,3th day,5th day,7th day. Results:In the non-infections.the count of the WBC was significantly different from the count on any other day;while in the infectious group the count of the WBC was signifiecantly higher than non-infections group besides that on the first day. Conclusion The count of the WBC gradually reduced as time gong and almostly on 7th day went into the normal range.If the count of the WBC was still high,there must be some infectional complications.