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Research on Injurious Factors and Risk Factors from Cardiopulmonary Bypass in Open Heart Surgery to Nervous System of Children with Congenital Heart Disease

Author: HeZuo
Tutor: XuZuo
School: Jinan University
Course: Pediatrics
Keywords: congenital heart disease cardiopulmonary bypass neuron-specific enolase nerous system injury
CLC: R726.5
Type: Master's thesis
Year: 2009
Downloads: 37
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Abstract


Objective:To observe the relationship between hematocrit（HCT）,arterial oxygen （PaO2）,arterial partial pressure of carbon dioxide（PaCO2）,CPB time and plasma NSE & S-100βlevels in the process of cardiopulmonary bypass（CPB） in open heart surgery.Methods:Choose 40 children with congenital heart disease in Cardiac Surgery Department of Wu Jing Zong Dui Hospital of Guangdong Province from January to April,take their blood samples to measure HCT,PaO2 and PaCO2 before,during and after CPB,and simultaneously separate the plasma which should be stored in fridge with a temperature of-70°.At the same time 30 children in the same hospital will be chosen for comparison.ELLSA will be adopted to quantitatively measure the NSE and S-100βlevels of both groups.Results:①The differences of plasma NSE and S-100βof pre-CPB and control groups are not significant（P＞0.05）;②The differences in plasma NSE and S-100βprotein during and after CPB of the children in both the fight to left and left to right shunt groups are of no significance（P＜0.05）;③When CPB starts,plasma NSE keeps surging as time goes by,from（8.28±17.01）μg/L to（38.84±23.80）μg/L,and S-100βalso increases from（3.11±2.74）μg/L to（9.37±6.24）μg/L.The differences are significant（P＜0.05）;④Such three factors as CPB time,HCT and PaCO2 have close relations with plasma NSE and S-100βlevel（P＜0.10）;⑤The OR of Pa（CO2）＜29 mmHg was 6.93（OR95%CI= 1.53-31.38）;⑥The OR of CPB temperature＞26℃was 6.0（OR95%CI=1.08-33.27）;⑦The OR of aortic clamping time＞50minutes was 5.67（OR95%CI= 1.17-17.37）;⑧The OR of CPB time＞78minutes was 4.50（OR95%CI=1.17-17.37）;⑨The OR of HCT＜0.25 was 10.23（OR95%CI=1.12-93.34）.Conclusions:According to the blood gas analysis,reduction of CPB time and regulation of HCT and partial pressure of carbon dioxide within a normal scale can reduce central nervous system injury complications.

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CLC: > Medicine, health > Pediatrics > Pediatric surgery > Surgery in children of all physiological systems
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