低体重先心病患儿体外循环肺保护65例临床分析

目的探讨〈10kg先心病患儿的体外循环管理中的肺保护情况。方法65例低体重先心病惠儿在体外循环下行外科矫治术。采用膜式氧合器，预充量550-750ml，心肌保护采用改良St.Thomas液。45例使用人工肾透析器改良超滤（MUF）。结果主动脉阻断时间（34.3±21.6）min，体外循环时间（62.2±23.7）min，气管插管机械通气时间（10.1±8.3）h。转流过程平稳，全部顺利停机。结论在低体重先心病患儿的心脏直视手术中，选择适当的手术时机，选用生物相容性好的CPB用品，术中给予良好的液体与呼吸管理，有效的药物保护，对保护肺功能有一定作用，是确保体外循环成功的关键。

Analysis of pulmonary protection in low weight infants with congenital heart disease:a report of 65 cases

Objective To summarize the experience of the cardiopulmonary bypass（CPB） management in infants weighted less than 10kg with congenital heart disease. Methods 65 cases were underwent open heart operation with cardiopulmonary bypass with membrane oxygenator and cardioplegia by repcrfusion with modified St. Thomas solution. The primed volume were 550 to 750ml. 45 cases were used modified ultrafiltration after bypass. Results The CPB duration was （62.2±23.7） min and the ascending aorta blockage time was（34.3±21.6）min. The ventilation time was （10.1±8.3 ）h in ICU. Conelusion Perfect management of CPB during child open heart surgery is beneficial to pulmonary protection.