摘要
目的探讨降低体外循环预充量,减少低体重成人患者库存红细胞用量的方法。方法将60例体重在40-60kg的患者随机分为三组：A组（Dideco905膜式氧合器,儿童管道）,B组（希健成人膜式氧合器,儿童管道）,C组（JostraVKMO70000膜式氧合器,成人管道）。观察三组患者实际预充量、复温时间、术中用血例数、ICU 24 h内用血例数、术后带管时间,监测转机前（T0）、转中（T1）、复温（T2）、停机（T3）、ICU 0 h（T4）、ICU 1 h（T5）、ICU 3 h（T6）血气指标。结果三组在复温时间、术后带管时间,术中及术后ICU 24 h内用血量无统计学差异（P〉0.05）。C组预充量大于A,B两组（P〈0.05）。血红蛋白浓度在T1、T2时间点有统计学差异（P〈0.05）,其余各时间点无统计学差异（P〉0.05）,T1、T2时间点进行组间比较,C组低于A、B两组（P〈0.05）。结论通过改良体外循环预充管道,减少了预充液对低体重患者血红蛋白稀释的影响,减少了围术期库存红细胞的应用机率。
Objective To evaluate the effect of decreasing the extracorporeal circulation（ ECC） priming volume for low-weight adults on reducing allogeneic blood transfusion in cardiac surgery. Methods Sixty low-weight adults（ 40-60 kg） were randomly divided into the following three groups： Group A（ Dideco 905 oxygenator,children ECC circuit）,group B（ Xijian adult oxygenator,children ECC circuit）,group C（ Jostra VKMO7000 oxygenator,adult ECC circuit）. Intra and post-operative（ up to 24 hours after ICU administration） transfusion were collected. Rewarming time,priming volume and extubation time were also recorded. The blood gas analysis was performed at the following time points： before ECC（ T0）,after X-clamp（ T1）,rewarming（ T2）,conclusion of ECC（ T3）,arriving at ICU（ T4）,1 h and 3 h after ICU administration（ T5 and T6）. Results There was no significant difference of rewarming time,extubation time and peri-operative RBC transfusion among the three groups（ P 〉0.05）. Compared with group A and B,group C had larger priming volume（ P〈 0.05）. Hemoglobin（ Hb） concentrations at T1 and T2 were lower in group C. Conclusion The application of decreasing priming volume for low-weight adults can mitigate hemodilution and reduce the probability of peri-operative RBC transfusion.
出处
《中国体外循环杂志》
2014年第3期162-164,共3页
Chinese Journal of Extracorporeal Circulation
关键词
体外循环
节约用血
Extracorporeal circulation
Blood conservation
