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目的:比较不同超滤法对小儿先心术后凝血功能的影响。方法:将60例先天性心脏病患儿随机分成3组,分别为改良超滤组(A组),平衡超滤+改良超滤组(B组)和常规体外循环,不用超滤(C组)。监测患儿体外循环(CPB)前和CPB后的血小板计数(PLT)、CPB前的活化凝血时间(ACT)、CPB后30 min及60 min的ACT、CPB时间及术后出血量。结果:CPB前后的PLT差值、出血量A组与C组,B组与C组差异有统计学意义(P<0.05),而A组与B组比较无统计学差异(P>0.05);三组体外循环转流时间和CPB前后不同时间ACT的差值无统计学差异。结论:改良超滤法及平衡超滤+改良超滤法均可提高先心病患儿术后PLT水平并减少出血量,而平衡超滤法对凝血功能没有明显的保护作用。
Objective: To compare the effect of different ultrafiltration on coagulation function in children after heart surgery. Methods: Sixty children with congenital heart disease were randomly divided into three groups: modified ultrafiltration group (A), balanced ultrafiltration + modified ultrafiltration group (B) and conventional cardiopulmonary bypass without ultrafiltration ). The platelet count (PLT) before CPB and after CPB, the activated clotting time (CPI) before CPB, the ACT, CPB time at 30 min and 60 min after CPB and the amount of postoperative bleeding were monitored. Results: There were significant differences in PLT, hemorrhage between group A and group C, group B and group C before and after CPB (P <0.05), but there was no significant difference between group A and group B (P> 0.05). There was no significant difference in ACT between the three groups in CPB time and before and after CPB. CONCLUSION: Modified ultrafiltration and balanced ultrafiltration plus modified ultrafiltration can both improve the postoperative PLT level and reduce the amount of bleeding in patients with CHD, whereas balanced UF has no obvious protective effect on the coagulation function.