腔静脉负压辅助引流在低体重患儿手术中的应用.docVIP

腔静脉负压辅助引流在低体重患儿手术中的应用 目录 TOC \o 1-9 \h \z \u 目录 1 正文 1 文1：腔静脉负压辅助引流在低体重患儿手术中的应用 1 1 资料与方法 2 2 结果 3 3 讨论 4 文2：经桡动脉冠状动脉介入治疗在低体重患者中的应用 5 1 材料与方法 6 2 结果 7 3 讨论 7 参考文摘引言： 9 原创性声明（模板） 10 文章致谢（模板） 10 正文 腔静脉负压辅助引流在低体重患儿手术中的应用 文1：腔静脉负压辅助引流在低体重患儿手术中的应用 The Application of Vena Cava Negative Pressure Assist Drainage in The Low Body Weight Infants Abstract: OBJECTIVE To retrospectively summarize the experience of the management of extracorporeal circulation (ECC) with the technique of vena cava negative pressure assist drainage in the low body weight infants (18 cases) with congenital heart diseases. METHODS The clinical date and ECC conditio were retrospectively analyzed. RESULTS 18 infants (boy 12 cases, girl 6 cases) were included in the study. The age ranged from 6 months to 23 months, and body weight from kg to 10 kg. ECC duration ranged from 28 minutes to 249 minutes, and occlusion time of the ascending aorta from 8 minutes to 135 minutes, all the infants were successfully weaned from the machine. One case died after operation. CONCLUSION Use of the vena cava negative pressure assist drainage technique in cardiopulmonary bypass of the low body weight infants can eure satisfactory vena cava drainage, reduce the primed volume maximmaly, provide adequate perfusion, aid to maintain the stable of the internal environment, the desirable Hct and the reasonable ratio of colloid and crystalloid. Key words： Extracorporeal circulation;Infants;Low body weight;Vena cava negative pressure;Assist drainage 回顾性总结本院自2005年12月至2006年5月对18例低体重婴幼儿先天性心脏病患儿在体外循环（extracorporeal circulation，ECC）过程中采用腔静脉负压辅助引流技术进行管理的经验。 1 资料与方法 临床资料 全组病例18例，男12例，女6例，年龄6～23m，体重～10 kg，手术类型及病例数见表1。 ECC方法 人工心肺机均使用STOCKERT-Ⅲ型，人工肺采用dideco901、902及国产西京婴儿膜肺，国产一次性婴幼儿微栓过滤器、管道、插管、灌注针、左心吸引头、直腔静脉插管、超滤器，预充液采用乳酸钠林格液、碳酸氢钠、20％白蛋白、血浆、抑肽酶、抗生素、肝素、速尿、20％甘露醇、6－氨基己酸、激素。根据婴幼儿术前红细胞比积（Hct）加入适量的红细胞维持Hct ～，连续监测平均动脉压、中心静脉压、泵压、鼻咽温和肛温。定时监测血气、血糖、ACT，采用浅低温中高流量、中低温中低流量、深低温低流量三种ECC方法，全组ECC前均不加血液回收器，并进行膜肺改装（封闭空余的吸引