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目的探讨简单属先天性心脏病患儿实施无血手术的可行性,以应对血液资源紧张现状、提高临床科学合理用血水平。方法将57名9～20(16.32±2.08)kg简单属先天性心脏病手术患儿(包括房间隔缺损、室间隔缺损)分为无血(治疗)组(n=25)和输血(对照)组(n=32),比较2组的体外循环时间、阻断时间、术前至术后7 d红细胞比容、术中至术后尿量及胸腔积液引流量、ICU天数、术后住院天数、总住院天数和住院费用。结果 2组手术患儿的体外循环时间、阻断时间、术前至术后7 d红细胞比容、术中至术后尿量及胸腔积液引流量、ICU天数和总住院天数无明显差异(均为P>0.05);术后住院天数:无血组(7.56±1.50)d vs输血组(8.88±2.12)d(P<0.05);住院费用:无血组(28 441.65±2 489.90)元vs输血组(30 189.46±4 892.37)元(P<0.05)。结论 9～20 kg的简单属先心病患儿可在不输注任何血液制品的情况下安全手术,无血手术在一定程度上缩短了这类患儿的住院时间,减少了住院期间花费,值得在先天性心脏病患儿手术治疗中提倡和推广。
Objective To investigate the feasibility of bloodless surgery in children with simple congenital heart disease in order to cope with the current situation of blood resource shortage and improve the clinical scientific and reasonable blood levels. Methods Fifty-seven infants with congenital heart disease (including atrial septal defect and ventricular septal defect) undergoing 9 ~ 20 (16.32 ± 2.08) kg simple operations were divided into two groups: bloodless treatment group (n = 25) (N = 32). The extracorporeal circulation time, the blocking time, the hematocrit before operation and 7 days after operation, the amount of urine output during the operation and postoperative hydrothorax, the number of ICU days, the postoperative hospital stay Days, total hospital days and hospital costs. Results There were no significant differences in cardiopulmonary bypass time, occlusion time, hematocrit from preoperative to postoperative 7 days, intraoperative to postoperative urinary volume and pleural effusion volume, ICU days and total hospitalization days (P> 0.05). The days of postoperative hospital stay were: no blood group (7.56 ± 1.50) d vs. blood transfusion group (8.88 ± 2.12) d vs blood transfusion group (30 189.46 ± 4 892.37) yuan (P <0.05). Conclusion Children with simple heart disease of 9 ~ 20 kg can safely operate without any infusion of blood products. Bloodless surgery can shorten the hospitalization time and reduce the cost of hospitalization to a certain extent, which is worth In children with congenital heart disease surgery to promote and promote.