两种血浆代用品对婴幼儿体外循环术后转归的影响.doc

两种血浆代用品对婴幼儿体外循环术后转归的影响 目录 TOC \o 1-9 \h \z \u 目录 1 正文 1 文1：两种血浆代用品对婴幼儿体外循环术后转归的影响 1 1 资料与方法 2 2 结 果 4 3 讨 论 4 文2：关于婴幼儿体外循环 5 1 概况 6 2 评价 7 3 未来 9 参考文摘引言： 11 原创性声明（模板） 12 文章致谢（模板） 13 正文 两种血浆代用品对婴幼儿体外循环术后转归的影响 文1：两种血浆代用品对婴幼儿体外循环术后转归的影响 Abstract: OBJECTIVE To observe the changes of lactate level and postoperative outcome following 4% succinylated gelatin (Gelofusine) or 6% hydroxyethyl starch 130/(Voluven) priming for extracorporeal circulation (ECC) in infants. METHODS 30 cases underwent congenital open heart surgery were randomly divided into two groups: Gelofusine group (n=15) with 4%Gelofusine prime; Voluven group (n=15) with 6% Voluven prime. The volume of plasma substitutes and the volume of homologous trafusion during ECC were recorded. The lactic acid concentration at ECC 15 min, 5 min and 2 h after weaning from ECC， and the hemoglobin at ECC 15 min and 2 h after weaning from ECC were measured. Also the chest drainage, urine output after ECC 24 h, recovery time, mechanical ventilating time, the length of ICU stay, the incidence of postoperative complication, postoperative dopamine / dobutamine doses, creatinine and urea nitrogen content after the surgery were recorded. RESULTS These two groups were all recovery well. There were no significant difference in lactic level and postoperative outcome between the two groups. CONCLUSION Gelofusine and Voluven are safe colloid solution for ECC priming in infants, they are no effect on lactate level, postoperative outcome and the complication. Key words： Plasma substitutes; Infants; Extracorporeal circulation; Gelofusine; Voluven; 输血有很多不良反应，少输血或不输血是心脏外科手术的目标之一。胶体液是重要的血浆代用品，临床上广泛使用的是4%琥珀酰明胶注射液（佳乐施）和6%羟乙基淀粉130/注射液（万汶），但它们用于婴幼儿报告较少。本研究旨在观察婴幼儿体外循环（extracorporeal circulation，ECC）采用佳乐施和万汶预充对术中乳酸及术后转归的影响。 1 资料与方法 研究对象 2007年7月至9月，30例择期行先天性心脏病心内畸形矫治术的婴幼儿患者，随机分为2组：佳乐施组和万汶组，每组15例。ECC分别采用佳乐施和万汶预充。两组患儿一般情况见表1。 方法 全组采用静吸复合麻醉，ECC使用STOCKERTⅢ型或SAR 7000型体外循环机，采用西京婴儿型膜肺或TERUMO婴儿型膜肺。应用佳乐施或万汶、去白细胞的红细胞、血浆