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目的 探讨体外循环前后的各种因素对儿童心肌地高辛含量的影响。方法 儿童先天性心脏病室间隔缺损肺高压病人，口服维持剂量地高辛１ 周以上，体外循环前后各取右心耳５０ ｍｇ 测量心肌地高辛含量，将可能影响心肌地高辛含量的各种因素进行多因素的逐步回归分析，其结果结合临床综合考虑，从而探讨影响心肌地高辛含量的诸因素。结果 术前心肌地高辛含量与病人术前肾功能（ＢＵＮ） 、血清总蛋白及术前血球压积、血红蛋白有关；体外循环结束时的心肌地高辛含量与术中的停跳液及预充液量、术前地高辛按体表面积计算的用药剂量、手术结束时的总蛋白、血液ｐＨ 值以及血清钠镁离子浓度有关。结论 影响小儿体外循环前后心肌地高辛含量的因素各有不同；术前主要与肾功能、血球压积及总蛋白有关，而停机时则与术前的用药时间、用药剂量有关外，还与术中影响心肌与地高辛结合的酸碱平衡及钠镁离子浓度及与是否造成心肌脱水因素的机器预充及停跳液量相关，在临床的用药过程中应综合考虑。
Objective To investigate the effect of various factors before and after cardiopulmonary bypass on the content of digoxin in children. Methods Child patients with congenital heart disease with ventricular septal defect and pulmonary hypertension under oral maintenance of digoxin for more than 1 week before and after cardiopulmonary bypass each taking 50 mg of myocardial digoxin content, may affect various factors of myocardial digoxin content Multifactorial stepwise regression analysis, the results combined with clinical considerations, to explore the factors that affect the content of myocardial digoxin. Results The preoperative myocardial digoxin content was related to the preoperative renal function (BUN), total serum protein, preoperative hematocrit and hemoglobin. Cardiac digoxin levels at the end of cardiopulmonary bypass were significantly correlated with intraoperative cardioplegia and preoperative cardioplegia Fluid volume, preoperative digoxin by body surface area calculated dose, total protein at the end of surgery, blood pH and serum sodium-magnesium concentration. Conclusions The factors influencing the content of digoxin before and after cardiopulmonary bypass in children are different. Preoperative is mainly related to renal function, hematocrit and total protein, while the downtime is related to the preoperative medication time and dose, Intraoperative impact of myocardial and digoxin combination of acid-base balance and concentration of sodium and magnesium and myocardial dehydration factor whether the cause of the machine pre-charge and stop the amount of fluid related to the clinical medication should be taken into account.