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目的评估改良超滤(MU F)对婴幼儿心内直视术后血液流变学的影响。方法选取需行手术治疗、体重<10kg的室间隔缺损(V SD)合并肺动脉高压(PH)患者22例,按住院号的奇、偶数分为对照组(10例,尾数为奇数者)和实验组(12例,尾数为偶数者)。对照组体外循环(CPB)结束后不行MU F,实验组于CPB停机后行MU F,超滤时间10~15m in,超滤流量10~15m l/m in.kg。分别于术前、CPB停机时、CPB后15m in/MU F结束时、术后2h和24h 5个时间点采集桡动脉血2.5m l,采用M DK-3200双通道全自动血液流变测试分析仪检测血液流变学相关指标的变化。结果实验组MU F结束时血红蛋白、红细胞压积、红细胞计数、屈服应力、血浆粘度、全血高切粘度、全血中切粘度、全血低切粘度、全血高切还原粘度、全血中切还原粘度、全血低切还原粘度和卡松粘度均较对照组CPB后15m in明显升高(P<0.05);红细胞变形指数、红细胞聚集指数各时间点两组间比较差异均无统计学意义(P>0.05)。结论使用MU F可明显提高CPB后患者的血红蛋白、红细胞压积、红细胞计数,婴幼儿CPB后采用MU F,其血液粘度高于未行MU F患者。
Objective To evaluate the effect of modified ultrafiltration (MU F) on hemorheology after open heart surgery in infants and young children. Methods Twenty-two patients with ventricular septal defect (V SD) and pulmonary hypertension (PH) weighing <10 kg undergoing surgical treatment were selected and divided into control group (10 patients with odd-numbered mantissa) and experiment Group (12 cases, mantissa is even). In the control group, no MUF was observed after cardiopulmonary bypass (CPB), while in the experimental group, MUF was performed after CPB shutdown. The ultrafiltration time was 10-15 mins and the ultrafiltration flow rate was 10-15 m l / m in.kg. Radial artery blood 2.5 ml was collected before operation, CPB shutdown, 15 mins / MU F after CPB, and 5 hours after operation at 2 h and 24 h postoperatively respectively. M DK-3200 dual-channel automatic hemorheology analyzer Detect changes in hemorheology-related indicators. Results In the experimental group, the hemoglobin, hematocrit, erythrocyte count, yield stress, plasma viscosity, whole blood high shear viscosity, whole blood shear viscosity, whole blood shear viscosity, whole blood shear viscosity, Cut reduction viscosity, whole blood low cut reduction viscosity and Casson viscosity than the control group after 15min CPP increased significantly (P <0.05); erythrocyte deformability index, erythrocyte aggregation index at any time point between the two groups showed no statistical difference Significance (P> 0.05). Conclusions The use of MU F can significantly improve hemoglobin, hematocrit and erythrocyte count in patients after CPB. The MUF in infants after CPB is higher than that in patients without MUF.