先天性心脏病患儿应用体外循环无血浆预充治疗的临床评价
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摘要
目的:探讨先天性心脏病患儿应用体外循环无血浆预充治疗的临床评价。方法:选择本院2013年2月至2016年2月收治的先天性心脏病患儿54例进行回顾性分析,根据治疗方法的不同分为血浆组及佳乐施组各27例,比较分析两组患者治疗前及治疗后血液学参数指标水平、凝血功能指标水平、肝肾功能指标水平,同时观察两组患儿呼吸机的使用时间、ICU时间及住院时间。结果:治疗后,两组患者的血液参数指标水平较治疗前显著升高(P<0.05),且血浆组的血液参数指标水平与佳乐施相比无明显差异(P>0.05)。治疗后,两组患者的凝血功能指标水平较治疗前显著升高(P<0.05),且血浆组的凝血功能指标水平与佳乐施相比无明显差异(P>0.05)。治疗后,两组患者的肝肾功能情况较治疗前显著改善(P<0.05),且血浆组的肝肾功能情况与佳乐施相比无明显差异(P>0.05)。观察两组患儿治疗后的恢复情况,结果显示:血浆组患儿呼吸机时间、ICU时间、住院时间与佳乐施组患儿相比无明显差异(P>0.05)。结论:采用佳乐施对先天性心脏病患儿进行预充,在维持患儿的凝血功能、肝肾功能及血液参数指标等方便具有同血浆同样的效果,故佳乐施可代替血浆用于先天性心脏病患儿体外预充,减少血浆的使用量。
Objective: To explore the clinical evaluation of extracorporeal circulation without plasma pre-filling in children with congenital heart disease. Methods: 54 cases with Congenital heart disease in children failures were researched,who from May 2013 to May 2016. According to random number table,they were divided into observation group and control group,27 cases in each group.The levels of hematological parameters,coagulation function and liver and kidney function were measured before and after treatment. The duration of ICU,ICU and hospital stay were also observed. Results: After treatment,the blood parameters of the two groups were significantly higher than those before treatment( P <0.05). After treatment,the two groups of patients with blood coagulation index level was significantly higher than before treatment( P < 0. 05),and the plasma coagulation index level was no significant difference( P >0.05). After treatment,the liver and kidney function of the two groups were significantly improved compared with before treatment( P < 0. 05),and the plasma group had no significant difference in liver and kidney function( P > 0.05). The recovery of the two groups after treatment was observed. The results showed that: there was no significant difference in the ventilation time,ICU time and hospital stay between the two groups( P >0.05). Conclusion: Pre-filling of congenital heart disease children with Galaxy has the same effect as plasma in maintaining coagulation function,liver and kidney function and blood parameters. Therefore,Galaxy can replace plasma for in vitro pre-filling of congenital heart disease children and reduce the use of plasma.
Objective: To explore the clinical evaluation of extracorporeal circulation without plasma pre-filling in children with congenital heart disease. Methods: 54 cases with Congenital heart disease in children failures were researched,who from May 2013 to May 2016. According to random number table,they were divided into observation group and control group,27 cases in each group.The levels of hematological parameters,coagulation function and liver and kidney function were measured before and after treatment. The duration of ICU,ICU and hospital stay were also observed. Results: After treatment,the blood parameters of the two groups were significantly higher than those before treatment( P <0.05). After treatment,the two groups of patients with blood coagulation index level was significantly higher than before treatment( P < 0. 05),and the plasma coagulation index level was no significant difference( P >0.05). After treatment,the liver and kidney function of the two groups were significantly improved compared with before treatment( P < 0. 05),and the plasma group had no significant difference in liver and kidney function( P > 0.05). The recovery of the two groups after treatment was observed. The results showed that: there was no significant difference in the ventilation time,ICU time and hospital stay between the two groups( P >0.05). Conclusion: Pre-filling of congenital heart disease children with Galaxy has the same effect as plasma in maintaining coagulation function,liver and kidney function and blood parameters. Therefore,Galaxy can replace plasma for in vitro pre-filling of congenital heart disease children and reduce the use of plasma.
引文
[1]赵明霞,苗晓蕾,冯正义,等.体外循环无血浆预充对紫绀型先天性心脏病患儿术后恢复与凝血功能的影响[J].中华小儿外科杂志,2014,35(11):816~821.
[2]陈思行,李霞,鲁中原,等.1岁以下先天性心脏病患儿体外循环下心脏术后甲状腺激素水平与延迟恢复的关系[J].中国循环杂志,2016,31(6):588~592.
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[5]王帅,邱永升,贾英萍,等.右美托咪定和丙泊酚对先天性心脏病患儿体外循环后脑保护作用的对比[J].当代医学,2016,22(24):1~3.
[6]李丹,卢仲毅.217例先天性心脏病患儿术后机械通气时间的影响因素分析[J].重庆医学,2013,(28):3379~3381.
[7]杨晓涵,于洪涛,张锐,等.全胸腔镜体外循环手术在儿童先天性心脏病中的应用[J].中国医师杂志,2016,18(8):1205~1207.
[2]陈思行,李霞,鲁中原,等.1岁以下先天性心脏病患儿体外循环下心脏术后甲状腺激素水平与延迟恢复的关系[J].中国循环杂志,2016,31(6):588~592.
[3]任建立,张义和,刘虎,等.体外循环无血浆预充应用于先天性心脏病患儿中的有效性与安全性[J].医学综述,2016,22(15):3044~3047.
[4]杨轶男,董湘玉,常欲晓,等.左向右分流型先天性心脏病患儿肺功能相关研究[J].临床儿科杂志,2012,30(8):724~726.
[5]王帅,邱永升,贾英萍,等.右美托咪定和丙泊酚对先天性心脏病患儿体外循环后脑保护作用的对比[J].当代医学,2016,22(24):1~3.
[6]李丹,卢仲毅.217例先天性心脏病患儿术后机械通气时间的影响因素分析[J].重庆医学,2013,(28):3379~3381.
[7]杨晓涵,于洪涛,张锐,等.全胸腔镜体外循环手术在儿童先天性心脏病中的应用[J].中国医师杂志,2016,18(8):1205~1207.