腔静脉负压辅助引流在低体重患儿手术中的应用

目的 回顾性总结本院18例10 kg以下低体重婴幼儿先天性心脏病手术过程中选择性应用腔静脉负压辅助引流（vacuum assistant venous drainage,VAVD）进行体外循环（extracorporeal circulation,ECC）的管理经验.方法 全组收集了2005年12月至2006年5月的18例10kg以下低体重婴幼儿先天性心脏病手术的临床资料（年龄、性别、体重、手术类型）和ECC情况（ECC设备、预充液组成、预充量、ECC时间、升主动脉阻断时间、血细胞压积）,并对上述资料进行回顾性分析.结果 全组病例18例,男12例,女6例,年龄6～23m,体重4.8～10kg,ECC时间28～249min,升主动脉阻断时间8～135min,全组病例均顺利脱机,一例术后死亡.结论 在低体重婴幼儿ECC过程中应用腔静脉负压辅助引流技术可以保证良好腔静脉引流、最大限度地减少预充量、提供适当的流量灌注、维持合理的内环境和血细胞压积、维持理想的晶胶比.

The Application of Vena Cava Negative Pressure Assist Drainage in The Low Body Weight Infants

OBJECTIVE To retrospectively summarize the experience of the management of extracorporeal circulation(ECC) with the technique of vena cava negative pressure assist drainage in the low body weight infants(18 cases) with congenital heart diseases.METHODS The clinical date and ECC conditions were retrospectively analyzed.RESULTS 18 infants(boy 12 cases,girl 6 cases) were included in the study.The age ranged from 6 months to 23 months,and body weight from 4.8 kg to 10 kg.ECC duration ranged from 28 minutes to 249 minutes,and occlusion time of the ascending aorta from 8 minutes to 135 minutes,all the infants were successfully weaned from the machine.One case died after operation.CONCLUSION Use of the vena cava negative pressure assist drainage technique in cardiopulmonary bypass of the low body weight infants can ensure satisfactory vena cava drainage,reduce the primed volume maximmaly,provide adequate perfusion,aid to maintain the stable of the internal environment,the desirable Hct and the reasonable ratio of colloid and crystalloid.