体外循环超滤法影响小儿心内直视术患者血糖和血乳酸水平的研究

目的本研究旨在探讨体外循环超滤法对小儿心内直视术患者血糖和血乳酸的影响及临床意义.方法62例小儿先心病患者(男39例,女23例,体重9.5～20kg,年龄平均2.5岁)随机分成AB两组,A组用5%葡萄糖预充,B组无糖预充,各组再分成超滤组和对照组,两组病种基本相同.超滤组和对照组在复温前、停机时,分别采血和超滤液测定血糖和乳酸,进行对比.结果A组和B组超滤后血清中血糖相比(P＜0.01),两组统计学差异有显著性.超滤组与对照组血糖和乳酸浓度,无明显统计学差异.而超滤液中含有较高浓度糖和乳酸.结论无糖预充可以降低血糖和乳酸,用超滤法可直接排除心内直视术小儿患者高血糖和高乳酸,减少神经系统的受损,值得临床推广应用.

The Effect of Ultrafiltration on Blood Content of Gluose and Lactate for Children Undergoing Cardiopulmonary Bypass

Objective : To study the effect of ultrafiltration on blood content of glucose and lactate for children undergoing cardiopulmonary bypass. Method: 62 cases were randomised divided into group A with glucose priming and group B with none-glucose priming. Both two groups were subdivided into ultrafiltration group and control group, Blood sample and ultrafiltrative fluid were taken for measurement of concentration of glucose and lactate before rewarming and post-CPB. Results: There were significant difference in serum concentration of glucose and lactate between group A and group B (P<0. 05). No difference between ultrafiltration group and control group. But ultrafiltrative fluid contained high concentration of glucose and lactate. Conclusions: None-glucose priming may reduce serum concentration of glucose and lactate. Ultrafiltration transfer much glucose and lactate out of circulation. It may avoid some postoperative neurological complication associated with high content of blood glucose and lactate.