论文部分内容阅读
６７例患先心病的婴儿在体外循环下接受心脏直视手术，稀释后血色素都维持于８０～１００ｇ／Ｌ，对大多数病例均采用中低温高流量灌注。按基本方法的差异分为Ａ（３０例）、Ｂ（３７例）两组。Ａ组中１２例因尿少在ＣＰＢ过程中加用了血液超滤；Ｂ组在ＣＰＢ过程中持续输注多巴胺３～４μｇ／ｋｇ／ｍｉｎ，该组机器中的余血７例经离心后将血球部份输回体内。两组在ＣＰＢ结束时，在平均尿量、血浆游离血红蛋白和动脉血乳酸含量及血色素尿均存在明显差异（ｐ＜０．０１或＜０．０５）。作者认为防止过度稀释，维持适当的胶体渗透压，在ＣＰＢ过程中充分的流量和应用低浓度多巴胺增加排尿及机器余血离心后输回，对减轻婴儿水负荷，维持水电解质平衡有较大的临床意义。
Sixty-seven infants with CHD underwent open heart surgery under cardiopulmonary bypass. Hemoglobin was maintained at 80-100 g / L after dilution. In most cases, low-temperature high-flow perfusion was used. According to the basic method of difference is divided into A (30 cases), B (37 cases) two groups. A group of 12 cases due to oliguria in the process of CPB plus blood ultrafiltration; B group continued infusion of dopamine in the process of CPB 3 ~ 4μg / kg / min, the remaining 7 cases of the group of machines after centrifugation will be centrifuged Blood cells partially returned to the body. At the end of CPB, there was a significant difference (p <0.01 or <0.05) in mean urine volume, plasma free hemoglobin and arterial lactate content and hemoglobinuria. The authors believe that to prevent over-dilution, to maintain the appropriate colloid osmotic pressure, adequate flow in the CPB process and the application of low concentrations of dopamine to increase urination and the machine back to spare after centrifugation, to relieve infant water load, maintain water and electrolyte balance greater Clinical significance.