应用负平衡超滤对婴幼儿含血预充液进行生理化调整的临床研究（临床医学范文）.docVIP

应用负平衡超滤对婴幼儿含血预充液进行生理化调整的临床研究（临床医学范文） 目录 TOC \o 1-9 \h \z \u 目录 1 正文 1 文1：应用负平衡超滤对婴幼儿含血预充液进行生理化调整的临床研究 1 1 资料与方法 2 2 结 果 3 文2：应用负平衡超滤对婴幼儿含血预充液进行生理化调整的临床研究 4 1 资料与方法 5 2 结 果 6 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） 11 正文 应用负平衡超滤对婴幼儿含血预充液进行生理化调整的临床研究（临床医学范文） 文1：应用负平衡超滤对婴幼儿含血预充液进行生理化调整的临床研究 Abstract: OBJECTIVE The purpose of this study is to test the hypothesis that ultrafiltration and warming before cardiopulmonary bypass(CPB) adjust the priming solution with stored blood to reach a physiologic statues of infants blood. METHODS We randomly selected identical CPB circuits including tubing, arterial filter, ultrafilter and membrane oxygenator for 20 infants less than 10 kg undergoing cardic surgery. The priming solution included donor red cell, Plasmalyte-A, albumin and sodium bicarbonate. We run the pump and mixed the priming solution about 10 minutes at flow rate 1.5 L/min and maintained the temperature around 36℃ using heat-cooler. Blood samples were obtained from the stored red cell, mixed priming blood and after ultrafiltration for blood gas analyses and io measurement. RESULTS Compared to stored red cells, the level of lactic acid, blood glucose and K+ were significantly lower in mixed priming soultion(P0.05).The level of Hct, Cop, Lactic acid, blood glucose and K+ were significantly lower after ultrafiltration than before ultrafltration (P0.05).CONCLUSION The negative balanced ultrafiltration and warming of the priming solution can effectively reduce the side effects of stored red cell to children in hemodynamic and io level . Key words： Cardiopulmonary bypass; Priming solution; Donor blood; Ultrafiltration; Infant在婴幼儿体外循环(cardiopulmonary bypass，CPB)初期往往因大量低温及非生理状态的含库血预充液导致血流动力学不稳定、酸碱失衡、离子紊乱和室性心律失常的发生，进而引起心肌损伤[1]。有文献报道大量葡萄糖和乳酸等代谢中间产物会导致中枢神经系统功能紊乱，库血中的大量白细胞释放炎性介质会加重CPB中炎性反应[2-3]。我们在CPB前应用负平衡超滤技术对含血预充液进行超滤，旨在使其更接近生理水平，减轻库血中不良血液成分对婴幼儿CPB早期带来的危害。 1 资料与方法 1.1 CPB管道连接 随机选取20例体重小于10 kg婴幼儿患者的CPB预充管路。所有CPB管路均由同一个灌注师进行安装连接、预充排气。采用Stocker