摘要
目的：总结和分析体外循环有关参数对小儿心脏直视手术安全性的影响。方法：用ＳＰＳＳ统计程序对手术年龄、血液稀释、体外循环和主动脉阻断时间、平均动脉压、灌注流量、心脏复跳及手术死亡情况进行统计学处理，根据不同条件分别进行比较和分析。结果：手术年龄降低和血液稀释加深并未引起死亡率上升；体外循环和主动脉阻断具有相对的安全时限；在保证相对足够流量时，循环中的低血压不影响心脏复苏和手术预后；年龄、降温深度和主动脉阻断时间与心脏复跳有关；手术死亡的主要原因是低心输出量综合征。结论：血液稀释至血红蛋白７０ｇ／Ｌ、降温至２４～３０℃、适当选用４０～２００ｍｌ·ｋｇ－１／ｍｉｎ的灌注流量及冷晶体停搏液顺灌心肌保护法，可安全应用于体外循环时间１１０分和主动脉阻断时间８０分内的心脏直视手术。
Objective:To study the influence of certain parameters of cardiopulmonary bypass on the safety of open heart surgery in children. Methods:SPSS was used to analyse the significance of age,haemodilution,bypass and aortic cross clamp duration,mean arterial blood pressure,on the resumption of heart beat,perioperative mortality,etc. Results:Reduced age and increasing haemodilution did not increase the mortality.The bypass and aortic cross clamp duration had their safety limit.When the perfusion rate was relatively enough,low arterial pressure did not impair the resumption of the heart beat and prognosis of the patient.Resumption of the heart beat was related to age, hypothermia, duration of aortic cross clamp,etc.The major cause of death was low cardiac output syndrome. Conclusion:Hypothermia(24 30℃),haemodilution with Hb 70 g/L,perfusion rate 40 200 ml·kg -1 /min,and cold high potassium crystalloid cardioplegia are competent for routine open heart surgery of children at aortic cross clamp duration less than 80 minutes.
出处
《中国循环杂志》
CSCD
1996年第8期478-481,共4页
Chinese Circulation Journal
关键词
儿童
体外循环
Children
Cardiopulmonary bypass
Open heart operation (Chinese Circulation Journal,1996,11:478.)
