Objective To investigate the efficacy and safety of cardiopulmonary bypass(CPB) without prefilled plasma applied to children with congenital heart disease .Methods Total of 64 children receiving routine surgery treatment of congenital heart disease in Affiliated Hospital of Yan′an University from Jan . 2013 to Dec.2014 were included in the study,and divided into an observation group and a control group,32 cases each.The observation group received CPB with gelofusine as priming,the control group was given con-ventional fresh frozen plasma as CPB priming.The hematological parameters,coagulation,liver and kidney function as well as recovery time of the two groups were recorded and analyzed.Results After treatment,the platelets,prothrombin time,hemoglobin of the observation group and the control group were less than before treatment[observation group:(212 ±21) ×109/L vs (289 ±21) ×109/L,(13.6 ±1.0) s vs (14.6 ± 0.7) s,(117 ±18) g/L vs (134 ±21) g/L;control group:(218 ±21) ×109/L vs (291 ±20) ×109/L, (13.3 ±1.0) s vs (14.3 ±0.7) s,(112 ±29) g/L vs (130 ±27) g/L] (P<0.05).After treatment,the fibrin formation time since detection of the two groups were longer than before treatment [ observation group:(51.2 ±3.6) s vs (43.2 ±2.9) s;control group:(51.2 ±3.7) s vs (43.3 ±2.8) s] (P<0.05),MA, Maf,FLEV,Map were lower than before treatment [observation group:(49 ±3) mmHg vs (57 ±4) mmHg, (5.25 ±0.25 ) mmHg vs ( 14.32 ±2.76 ) mmHg, ( 1.4 ±0.3 ) g/L vs ( 2.7 ±0.9 ) g/L, ( 42.2 ± 3.3) mmHg vs (44.3 ±2.4) mmHg;control group:(49 ±3) mmHg vs (57 ±3) mmHg,(5.31 ±0.16) mmHg vs (14.37 ±2.81 ) mmHg, ( 1.5 ±0.4 ) g/L vs ( 2.7 ±0.8 ) g/L, ( 42.2 ±3.3 ) mmHg vs (44.3 ±2.4) mmHg] (P<0.01).Liver and kidney function of the two groups after treatment showed no significant difference (P>0.05).The ventilator time,ICU and hospital stay of the two groups had no signifi-cant difference(P>0.05).Conclusion Artificial colloid gelofusine applied as PCB priming has the same effect to plasma in hematology,liver and kidney function,blood coagulation and recovery time,so artificial colloid gelofusine can be used to replace plasma priming in CPB of treatment for children with congenital heart disease.%目的：探讨体外循环无血浆预充应用于先天性心脏病患儿中的有效性与安全性。方法选择2013年1月至2014年12月延安大学附属医院接诊的64例行先天性心脏病矫治术的患儿作为研究对象，采用随机数字表法分为观察组和对照组，各32例。观察组患儿应用琥珀酰明胶注射液作为体外循环预充液，对照组则采用常规新鲜冰冻血浆作为体外循环预充液。对两组患儿的血液学参数、凝血功能、肝肾功能以及恢复时间进行记录分析。结果治疗后，观察组和对照组患儿的血小板、凝血酶原时间、血红蛋白低于治疗前［观察组：（212±21）×109／L比（289±21）×109／L，（13．6±1．0）s比（14．6±0．7）s，（117±18）g／L比（134±21）g／L；对照组：（218±21）×109／L比（291±20）×109／L，（13．3±1．0）s比（14．3±0．7）s，（112±29）g／L比（130±27）g／L］（P＜0．05）。治疗后，两组患儿检测开始至最初纤维蛋白形成所用时间高于治疗前［观察组：（51．2±3．6）s比（43．2±2．9）s；对照组：（51．2±3．7）s比（43．3±2．8）s］（P＜0．05），最大幅度、通过纤维蛋白原所形成的最大幅度、定量检测纤维蛋白原含量、通过血小板所形成的最大幅度低于治疗前［观察组：（49±3）mmHg（1mmHg＝0．133kPa）比（57±4）mmHg，（5．25±0．25）mmHg比（14．32±2．76）mmHg，（1．4±0．3）g／L比（2．7±0．9）g／L，（42．2±3．3）mmHg比（44．3±2．4）mmHg；对照组：（49±3）mmHg比（57±3）mmHg，（5．31±0．16）mmHg比（14．37±2．81）mmHg，（1．5±0．4）g／L比（2．7±0．8）g／L，（42．2±3．3）mmHg比（44．3±2．4）mmHg］（P＜0．01）。两组患儿治疗后的肝肾功能指标比较差异均无统计学意义（P＞0．05）。两组患儿呼吸机时间、ICU时间和住院时间比较差异无统计学意义（P＞0．05）。结论人工胶体琥珀酰明胶注射液在应用于体外循环预充时，在血液学、肝肾功能、凝血功能以及恢复时间等和血浆预充的效果相同，因此人工胶体琥珀酰明胶注射液在对先天性心脏病患儿的治疗中，可代替血浆用于体外循环管路预充。
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