两种不同超滤置换液在患儿大容量零平衡超滤中的比较.pdfVIP

中国循环杂志 2014 年 11 月 第 29 卷 第 11 期（总第 197 期）Chinese Circulation Journal，November，2014，Vol. 29 No.11（Serial No.197） 917 临床研究 两种不同超滤置换液在患儿大容量零平衡超滤中的比较 曹凡，黄国栋，袁惠莉，白楠，王怀贞， 陈欣欣 摘要 目的：比较两种不同置换液在患儿大容量零平衡超滤（ZBUF）中的效果。 方法：2012-11 至 2014-02 选取主动脉缩窄深低温停循环手术的患儿 40 例，随机分为勃脉力 A 置换液组（n =21） 和改良置换液组（n =19），均在复温阶段以 15~20 ml/kg 流量行 ZBUF，直至直肠温 34℃停止。分别于转机前（T1），开 放升主动脉并补充完 Ca 剂之后 5 分钟（T2），ZBUF 结束（T3），停机后（T4）检测血气。记录术中体外循环相关时间， 观察并发症及术后恢复情况。 结果：两组术中血气结果比较：T3 时改良置换液组患者的血气 Ca 离子浓度明显高于勃脉力 A 置换液组（P 0.01）， 碱剩余于 T3 时均呈负数且绝对值改良置换液组明显小于勃脉力 A 置换液组（P 0.05），而 T1，T2，T4 差异均无统计 学意义（P 0.05）；其余各项指标组间比较差异均无统计学意义（P 0.05）。两组术后恢复指标均无统计学差异（P 0.05）。 结论：使用改良置换液较勃脉力可显著避免钙离子浓度降低和酸中毒，能为患者提供相对稳定的内环境。 关键词 零平衡超滤；勃脉力 A；体外循环 Comparison of High Volume Zero-Balanced Ultrafiltration With Different Replacement Fluid in Infant Patients CAO Fan, HUANG Guo-dong, YUAN Hui-li, BAI Nan, WANG Huai-zhen, CHEN Xin-xin. Heart Center, Guangzhou Women and Children’s Hospital, Guangzhou (510623) Guangdong, China Corresponding Author: CHEN Xin-xin, Email: zingerchen@163.com Abstract Objective: To compare the clinical effects of high volume zero-balanced ultrafiltration (ZBUF) with different replacement fluid in infant patients. Methods: A total of 40 infant patients who received aortic coarctation with deep hypothermic circulatory arrest operation in our hospital from 2012-11 to 2014-02 were summarized. The patients were randomized into 2 groups, Group A, the patients had ZBUF with plasmalyte A, n=21 and Group B, the patients had ZBUF with modified replacement fluid n=19. All patients received ZBUF (15-20) ml/kg during re-warming period until the temperature reached 34°C at rectum. Blood gas analysis were conducted at 4 time points as T1 (before CPB), T2 (open ascending aorta and 5 min after calcium perfusion), T3 (finishi