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目的探讨含血预充液超滤洗涤对婴幼儿心肺转流(CPB)期间内稳态的影响。方法施行先天性心脏病手术治疗患儿30例,随机均分为两组:A组术前利用CPB管道中血液超滤器对含血预充液进行超滤洗涤20min;B组预充液在CPB管道中循环20min。测定A组含血预充液超滤洗涤前、后及两组麻醉诱导后CPB前(T0)、升主动脉阻断10min(T1)、升主动脉开放10min(T2)和CPB结束时(T3)血气分析和电解质等指标。结果与B组比较,A组超滤后血液pH、PaO2、碱剩余值较超滤前升高(P<0.05),PaCO2、K+、乳酸(Lac)、BG、TNF-α浓度均降低(P<0.05)。A组Glu在T1、T2、T3时均低于B组(P<0.05);Lac在T2时低于B组(P<0.05)。结论含血预充液进行超滤洗涤预处理可降低库血的有害成份,减轻CPB期间血Lac和Glu水平升高,改善CPB期间机体内环境。
Objective To investigate the effect of blood prefilled ultrafiltration on the homeostasis of infants during cardiopulmonary bypass (CPB). Methods Thirty children with congenital heart disease undergoing surgery were randomly divided into two groups: Group A was pretreated with ultrafiltration of blood prefilled liquid with blood ultrafilter in CPB pipeline for 20 minutes; Group B prefilled CPB pipeline cycle 20min. The blood samples were collected before and after ultrafiltration (AFC), and before CPB (T0), ascending aorta 10 min (T1), ascending aorta 10 min (T2) and after CPB Blood gas analysis and electrolyte and other indicators. Results Compared with group B, the concentrations of PaCO2, K +, lactate (Lac), BG, and TNF-α in group A were significantly lower than those before ultrafiltration (P <0.05) <0.05). Glu in group A was lower than that in group B at T1, T2 and T3 (P <0.05); Lac at T2 was lower than that in group B (P <0.05). CONCLUSION: Preconditioning with blood preconditioning can reduce the harmful components of blood and reduce the increase of blood Lac and Glu during CPB and improve the body environment during CPB.