| Objective At present,the diagnosis and treatment of congenital heart disease in children has been greatly improved,the success rate of surgery is greatly improved,and the corresponding anesthesia technology has also made considerable progress.However,with the development of perioperative medicine,the prognosis of children gradually attracts attention.The new view that different liquid treatment programs can affect the prognosis of children.This observation by comparing the control group and experimental group children at each time point of blood gas analysis indicators,intraoperative and outpatient admission,cardiopulmonary bypass time,myocardial infarction time and ICU residence time and other perioperative data,to explore the application of open heart surgery in children by isotonic albumin on lung function in children with impact.Methods A retrospective analysis of 118 children who were treated in Tianjin Chest Hospital from January 2016 to December 2017.Exclusion criteria: other thoracic surgery(such as lung surgery)during the same period.The age of the children was 0~12 years old.According to whether the isotonic albumin was applied during operation,they were divided into two groups: the application of isotonic albumin treatment group(observation group)and the crystalloid fluid treatment group(control group),the observation group was 29 cases and the control group was 89 cases.In the observation group,the isotonic albumin was supplemented with 10ml/(kg·h)according to the body weight of the infants.Intraoperative blood transfusion was appropriately adjusted according to the hemoglobin(Hb),hematocrit(Hct),central venous pressure(CVP);the control group according to the same calculation method of liquid crystal.The perioperative blood gas analysis indexes of two groups were recorded;records of the two groups in the amount that during the infusion volume,amount of blood transfusion and CPB priming solution;two groups were recorded during the operation that the total amount of blood loss and urine volume;records of two groups of postoperative mechanical ventilation time,ICU residence time and the total hospitalization time.Observations 1.General data comparison: There was no significant difference in gender,age and weight between the two groups(all P> 0.05).2.Intraoperative records: two groups of children with the amount of admission data,the experimental group infusion was lower than the control group [(239 ± 178)VS(351.8 ± 222.3,P <0.05];while the control group of red blood cell transfusion was higher than the experimental group(0.7 ± 3.8)VS(0.6 ± 3.2),P <0.05].There was no significant difference between the two groups in the amount of plasma input,the volume of preflushed fluid,blood cells,plasma and blood loss(all P> 0.05).3.Perioperative blood gas analysis of two groups of indicators: there was no significant difference between the two groups of children with T1 A-a DO2 [(117.9 ± 58.3)VS(127.8 ± 92.1),P> 0.05],but the two groups of children at intraoperative 2 A-a DO2 values in the experimental group were significantly lower than those in the control group [(80.6 ± 43.3)VS(123.9 ± 62.8),P <0.05] after surgery 2 the A-a DO2 value of experimental group was lower than that in control group [(74.3 + 29)VS(100.1 + 31.3),P < 0.05];two groups were compared at each time point of K+,Na+,Cl-,Ca2+,HCO3-,Lac and BE,the difference was not statistically significant(all P > 0.05).4.Perioperative data of the two groups of children: experimental group mechanical ventilation time shorter than the control group [(16.1 ± 1.6)vs(22.1 ± 1.9),P <0.05],there was no significant difference in cardiopulmonary bypass time,myocardial block time,ICU residence time and total hospitalization time(all P> 0.05).Conclusion The application of isotonic albumin in infants undergoing open heart surgery can significantly improve postoperative pulmonary function and shorten the duration of mechanical ventilation,but there is no significant difference in ICU residence time and hospitalization time. |
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