摘要：目的 研究婴幼儿体外循环(CPB)下心脏直视手术时ACD库血预充对患者电解质、酸碱平衡及血浆白蛋白浓度的影响。方法 选择ASAⅠ-Ⅱ级先天性房间隔缺损(ASD)、室间隔(VSD)32例患者，CPB前机器预充枸缘酸(ACD)库血以维持患者术中红细胞比积(Hct)23~27%，检测库血及患者转流前、转流10min、停机前、停机后15min及术毕时血K+、Na+、Hct、HCO3-、Be、PCO2、PO2、Ca2+及血浆白蛋白浓度。结果 与患者转流前相比，转流中患者血钾浓度明显升高(P<0.05)，Be值明显下降(P<0.05)，血浆白蛋白浓度转流后较转流前下降(P<0.05)，手术完毕时逐渐恢复正常，转流后ica浓度较转流前无明显变化。结论 CPB过程中预充ACD库血可升高患者血钾，降低血Be值，而ica浓度无明显变化。

    关键词：体外循环; ACD库血;血液稀释;电解质

    Clinical Study of The Use of ACD Reserve Blood In Hemodilution of Infants Cardiopulmonary Bypass

    YANG Xiao-wen,XIANG Qiang,WANG Rong,DONG Ai-ping,WANG Li-shen

    (Department of Anesthesiology, Jingzhou Central Hospital.Hubei,434020 China)

    Abstract: OBJECTIVE To study the effect of ACD reserve blood used in the hemodilution of infants cardiopulmonary bypass.METHODS 32 cases of congenital ASD and VSD (ASA status Ⅰ-Ⅱ) at the age from 1 to 3 were randomly chosen. ACD reserve blood were used in hemodilution to keep the Hct vary at the range of 0.23~0.27 in CPB.The samples drawn from ACD reserve blood and the central venous tube at the following time intervals; before CPB、10min after CPB、 before pump-off、end of operation, were measured for the levels of K+、Na+、Hct、HCO3-、BE、PCO2、PO2、Ca2+ and albumin.RESULTS Compared with the sample taken before CPB, the concentration of K+ increased significantly after CPB (P<0.05), the BE value decreased significantly after CPB(P<0.05),the concentration of albumin decreased after CPB.CONCLUSION Used ACD reserve blood can increase the blood k+ and decrease the blood BE values, but no change in iCa2+ obviously. ......