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目的：总结和分析体外循环有关参数对小儿心脏直视手术安全性的影响。方法：用ＳＰＳＳ统计程序对手术年龄、血液稀释、体外循环和主动脉阻断时间、平均动脉压、灌注流量、心脏复跳及手术死亡情况进行统计学处理，根据不同条件分别进行比较和分析。结果：手术年龄降低和血液稀释加深并未引起死亡率上升；体外循环和主动脉阻断具有相对的安全时限；在保证相对足够流量时，循环中的低血压不影响心脏复苏和手术预后；年龄、降温深度和主动脉阻断时间与心脏复跳有关；手术死亡的主要原因是低心输出量综合征。结论：血液稀释至血红蛋白７０ｇ／Ｌ、降温至２４～３０℃、适当选用４０～２００ｍｌ·ｋｇ－１／ｍｉｎ的灌注流量及冷晶体停搏液顺灌心肌保护法，可安全应用于体外循环时间１１０分和主动脉阻断时间８０分内的心脏直视手术。
OBJECTIVE: To summarize and analyze the effect of extracorporeal circulation parameters on the safety of open heart surgery in children. Methods: Surgical age, hemodilution, cardiopulmonary bypass, aortic cross-clamping time, mean arterial pressure, perfusion flow rate, cardiac resuscitation and surgical death were statistically analyzed by SPSS statistical program, and were compared and analyzed according to different conditions. Results: Lower age and reduced hemodilution did not result in an increase in mortality. Extracorporeal circulation and aortic blockade had a relative safety margin. Circulatory hypotension did not affect cardiac recovery and surgical outcome when relatively adequate flow rates were achieved. Age , Depth of cooling and aortic cross-clamping time and heart resuscitation related; the main reason for surgical death is low cardiac output syndrome. CONCLUSIONS: The blood is diluted to hemoglobin 70g / L, cooled to 24-30 ℃, perfusion flow of 40 ~ 200ml · kg-1 / min and cold crystal cardioplegia cisterning myocardial protection method are selected properly, which can be safely applied to cardiopulmonary bypass time 110 points and aortic occlusion within 80 minutes of open heart surgery.