摘要
目的:探究平衡超滤技术在体外循环下心内直视手术治疗小儿先天性心脏病中的应用效果。方法:选取2021年1月—2022年12月在泰安市妇幼保健院治疗的先天性心脏病患儿86例,应用随机数字表法将其分为对照组(n=43)及观察组(n=43)。对照组行常规超滤,观察组行平衡超滤。对比两组不同时刻[体外循环前(T_(0))、超滤后即刻(T_(1))、术后24 h(T_(2))、术后48 h(T_(3))、术后72 h(T_(4))]患儿白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、超敏C反应蛋白(hs-CRP),比较两组患儿术前、术后即刻、术后24 h、术后48 h肺功能{肺泡-动脉血氧分压差[P(A-a)O_(2)]、肺动脉压(PAP)},比较两组患儿术后恢复情况(使用血管活性药物时间、呼吸机使用时间、ICU住院时间)。结果:T_(0),两组IL-6、IL-10、hs-CRP水平比较,差异均无统计学意义(P>0.05);两组IL-6水平在T_(1)、T_(2)、T_(3)、T_(4)均高于T_(0),且观察组T_(2)、T_(3)、T_(4)的IL-6均低于对照组,差异均有统计学意义(P<0.05);两组T_(1)、T_(2)、T_(3)、T_(4)的IL-10水平均高于T_(0),且观察组T_(1)、T_(2)、T_(3)、T_(4)的IL-10均低于对照组,差异均有统计学意义(P<0.05);两组hs-CRP水平在T_(1)、T_(2)、T_(3)、T_(4)均高于T_(0),且观察组T_(2)、T_(3)、T_(4)的hs-CRP水平均低于对照组,差异均有统计学意义(P<0.05)。术前,两组患儿P(A-a)O_(2)、PAP比较差异均无统计学意义(P>0.05);术后即刻、术后24 h、术后48 h两组P(A-a)O_(2)均高于T_(0),但观察组P(A-a)O_(2)均低于对照组,差异均有统计学意义(P<0.05);术后即刻、术后24 h、术后48 h,两组PAP均低于T_(0),且观察组PAP均低于对照组,差异均有统计学意义(P<0.05)。观察组使用血管活性药物时间、呼吸机使用时间、ICU住院时间均短于对照组,差异均有统计学意义(P<0.05)。结论:先天性心脏病患儿在心内直视手术中机体会出现炎症反应,平衡超滤技术可降低机体炎症反应,减轻机体损�
Objective:To investigate the application effect of balanced ultrafiltration technique in the treatment of pediatric congenital heart disease by direct intracardiac surgery under extracorporeal circulation.Method:A total of 86 children with congenital heart disease treated in Tai’an Maternity and Child Health Hospital from January 2021 to December 2022 were selected and divided into control group(n=43)and observation group(n=43)by random number table method.The control group received conventional ultrafiltration,and the observation group received balanced ultrafiltration.Interleukin-6(IL-6),interleukin-10(IL-10)and hypersensitive C reactive protein(hs-CRP)were compared between the two groups at different times[before cardiopulmonary bypass(T_(0)),immediately after ultrafiltration(T_(1)),24 h after surgery(T_(2)),48 h after surgery(T_(3)),72 h after surgery(T_(4))];the pulmonary function[P(A-a)O_(2),pulmonary artery pressure(PAP)]of the two groups were compared before,immediately after surgery,24 h after surgery and 48 h after surgery;the postoperative recovery(the time of using vasoactive drugs,the time of using ventilator,and the length of ICU stay)of the two groups of children were compared surgery.Result:T_(0),IL-6,IL-10,hs-CRP levels between the two groups were not statistically significant(P>0.05);the levels of IL-6 at T_(1),T_(2),T_(3) and T_(4) in both groups were higher than those at T_(0),and the levels of IL-6 at T_(2),T_(3) and T_(4) in observation group were lower than those in control group,the differences were statistically significant(P<0.05);the IL-10 levels at T_(1),T_(2),T_(3) and T_(4) in two groups were higher than those at T_(0),and the IL-10 levels at T_(1),T_(2),T_(3) and T_(4) in observation group were lower than those in control group,the differences were statistically significant(P<0.05);the hs-CRP levels at T_(1),T_(2),T_(3) and T_(4) were higher than those at T_(0),and the hs-CRP levels at T_(2),T_(3) and T_(4) in observation group were lower than those in control group,the difference
作者
尹记辉
YIN Jihui(Tai’an Maternity and Child Health Hospital,Shandong Province,Tai’an 271000,China)
出处
《中国医学创新》
CAS
2023年第26期10-14,共5页
Medical Innovation of China
关键词
平衡超滤技术
体外循环
心内直视手术
小儿先天性心脏病
炎症因子
Balanced ultrafiltration technique
Extracorporeal circulation
Direct intracardiac surgery
Paediatric congenital heart disease
Inflammatory factors
