天津医药 ›› 2018, Vol. 46 ›› Issue (5): 493-496.doi: 10.11958/20180553

• 综述 • 上一篇    下一篇

婴幼儿体外循环心脏直视手术的血液保护策略

蔡璐, 武婷   

  1. 天津市胸科医院灌注科, 天津市心血管病研究所 (邮编300222)
  • 收稿日期:2018-04-09 修回日期:2018-04-17 出版日期:2018-05-15 发布日期:2018-05-15
  • 通讯作者: 武婷 E-mail:ting_ting_wu@126.com
  • 基金资助:
    天津市卫计委科技基金

Blood conservation strategy in infants undergoing cardiopulmonary bypass during the open heart surgery

CAI Lu, WU Ting   

  1. Department of Perfusion, Tianjin Chest Hospital, Tianjin Cardiovascular Institute, Tianjin 300222, China
  • Received:2018-04-09 Revised:2018-04-17 Published:2018-05-15 Online:2018-05-15
  • Contact: Ting Wu E-mail:ting_ting_wu@126.com

摘要: 摘要: 在婴幼儿心血管手术中, 特别是复杂的先天性心脏病外科手术, 血液供需的利弊问题逐渐引起临床的关注。另外异体输血可能会导致传染性疾病的感染, 因而如何最大限度地减少术后出血, 降低异体血制品的使用频率, 同时避免血液破坏是当前亟需解决的热点问题。婴幼儿的凝血系统与成人相比较, 其发育尚未成熟, 而先心病手术日渐复杂化, 这使得维持婴幼儿凝血系统的稳态问题日益突出。本文就当前小儿心脏外科血液保护中的微小化体外循环 (CPB) 管路、 联合超滤技术、 负压辅助静脉引流、 血液稀释及预充、 抗纤溶药物的应用以及自体血液回收的应用进展作一系统性回顾, 为完善先心病患儿的血液保护策略提供参考。

关键词: 体外循环, 婴幼儿, 血液保护, 心脏直视手术

Abstract: Abstract: In the cardiovascular surgery of infants, especially in complex congenital heart surgery, the advantages and disadvantages of blood supply and demand have gradually attracted clinical attention. Besides, allogeneic blood transfusion may lead to the infection of infectious diseases. As a result, how to minimize postoperative bleeding, reduce the usage of allogeneic blood products, and avoid the damage of blood has become a hot issue for urgent consideration and solution. The blood coagulation system of infants is not mature compared with adults, and the operation of congenital heart disease is becoming more and more complex, which makes the issue of maintaining the blood coagulation system of infants become increasingly prominent. This paper provides a reference for perfecting blood conservation strategy of infants with congenital heart disease, which systematically reviews the application progress of minimized extracorporeal circulation circuits, combined ultrafiltration technology, vacuum assist venous drainage, blood dilution and priming, utilization of antifibrinolytic drugs, and application of autotransfusion.

Key words:  cardiopulmonary bypass, infant, blood conservation, open heart surgery