【摘要】 目的 采用综合措施进行血液保护，探讨心内直视手术不用库血，避免输血性感染性疾病的发生。 方法 (1)术前经腔静脉放血，按10～18ml/kg，同时经动脉供血管输注无血预充液，维持体液平衡，中度稀释血液(Hct0.20～0.25)体外循环结束，根据动静脉压及尿量全部回输剩余机血，术后加强利尿，浓缩血液。(2)在预充液中均加入抑肽酶，剂量6×10 5 KIU/kg。(3)外科手术认真止血。 结果 40例直视心脏手术患者，均未达到输血标准，围术期未输库血。术后48h总引流量平均296±58.21ml，患者出院前3天复查Hb均大于115g/L，Hct大于0.40，全组病例顺利康复。 结论 直视心脏手术，采用综合血液保护措施，可不输库血，避免输血性感染性疾病的发生。

    关键词 体外循环 血液保护 输血

    No allogeneic transfusion in open cardiac surgery of40cases

    He Jianchao，Cai Bing，Liu Changchun，et al.

    Department of Cardiac Surgery，The First Affiliated Hospital of Kunming Medical College，Kunming650032.

    【Abstract】 Objective The comprehension blood conservation was used in open cardiac surgery to protect pa-tients from infectious diseases transmitted by allogeneic transfusion.Methods (1)the blood was collected from venous(10ml/kg)and pumped solution through aortic artery.Moderate hemodilution was used.After cardiopulmonary bypass.The blood was all automtransfused.(2)To be used aprotinin(6×10 5 KIU/kg).(3)Bleeding was carefully treated.Re-sults The forty cases were not allogeneic transfusion.The average of drainage volume296±58.21ml post operated48hours.All patients discharged ......