摘要：目的 探讨离心泵对小儿体外循环(CPB)血小板功能的影响。方法 20例复杂先天性心脏病患儿随机分为离心泵组(n=10)和滚轴泵组(n=10)。离心泵组采用离心泵(Biopump BP50泵头)，滚轴泵组使用StockertⅢ心肺机(滚轴泵)，常规建立CPB，行心脏畸形根治术。分别于麻醉前(T1)、CPB结束即刻(T2)、CPB结束后24h(T3)取静脉血测定血小板计数、血小板颗粒膜蛋白-140(GMP-140)、血栓素B2(TXB2)和6-酮体-前列腺素F1α(6-keto-PGF1α)。结果 两组患儿CPB时间、阻断时间、最低鼻咽温度无显著性差异。T2期两组患儿血小板数量下降(P<0.05)，组间无显著性差异。T2期两组患儿GMP-140增高(P<0.05)，滚轴泵组增高更为显著(P<0.05)；滚轴泵组TXB2、6-keto-PGF1α水平超过离心泵组(P<0.05)。术后24h内离心泵组胸液量明显少于滚轴泵[离心泵组(6.4±4.1)ml/kg 比滚轴泵组(11.1±3.3)ml/kg，P<0.05]。两组患儿用血量和ICU时间没有显著差异。结论 离心泵较滚轴泵明显减少对血小板的破坏，但是临床结果没有明显优势。

    关键词：离心泵；小儿；体外循环；血小板功能

    Effect of Centrifugal Pump on Blood Platelet Functions during Cardiopulmonary Bypass in Children

    ZHOU Cheng-bin, ZHANG Jing-fang, ZHANG Xiao-hua, CHEN Ping, ZHUANG Jian, CHEN Xin-xin

    ( Department of Cardiac Surgery, Guangdong Provincial Cardiovascular Institute,Guangdong Guangzhou 510100, China)

    Abstract: OBJECTIVE To evaluate the effect of centrifugal pump on blood platelet functions during cardiopulmonary bypass(CPB) in children. METHODS Twenty children with complex congenital heart diseases scheduled for open-heart surgery with CPB were randomized to be perfused with either a centrifugal pump (n=10) or a roller pump (n=10). Blood samples were obtained for determination of platelet count, platelet guanosine monophosphate-140(GMP-140), thromboxane B2 (TXB2) and 6-keto-prostaglandin F1α (6-keto-PGF1α)before anesthesia, at the end of CPB and 24 hr after CPB. RESULTS There were no significant differences in preoperative or intraoperative parameters, including CPB time, cross-clamping time and minimum nasopharyngeal temperature. The reduction in platelet count at T2 in both groups were similar. In both groups platelet GMP-140 levels were significantly increased at T2, with the roller pump group being more elevated when compared with the centrifugal pump group (P<0.05). The increase of TXB2 and 6-keto-PGF1α levels was greater in the roller pump group at T2 (P<0.05). Chest drainage in the centrifugal pump group was remarkably lower than that of the roller pump group (P<0.05). There were no difference between the two groups in blood product requirements and duration of intensive care. CONCLUSION The centrifugal pump alleviated the platelet activation during bypass compared with the roller pump. However, there was no clinical evidence for the superiority of the centrifugal pump. ......