Clinical Significance Study Of Ascitic Fluid Drainage After Repair Of Complex Congenital Heart Disease In Infancy

Objective: To explore ascitic fluid drainage in management after repair of complex heart disease in infancy whether can reduce postoperative systemic inflammatory response syndrome (SIRS) and conducive to the early recovery of myocardial injury.Methods: Twenty children with complex congenital heart disease were randomly allocated into study group (n = 10) and control group (n = 10). In the study group , the patients were placed a drainage tube to shunt for forty-eight hours at left-lower abdomen(Michael Point asymmetric's position). Age, weight, aortic cross-clamp time, cardiopulmonary bypass (CPB) time, mechanical ventilation time, intensive care time and post-operative hospitalization time and other clinical indicators were monitored . The plasma IL-6,IL-10, troponin I (cTnI), acute-reactive protein (CRP) and white blood cell count (WBC) at pre-operative and 0h,12h, 24h, 48h postoperatively were measured in both groups. The volume of ascites as well as IL-6 and IL-10 levels in the ascites at post-operative 0h,12h, 24h, 48h were assessed.Results: Intensive care time of two groups had no significant difference (P> 0.05), but mechanical ventilation time, post-operative hospitalization time in the study group was shorter than the control group (P <0.05), notropic score also lower than the control group (P <0.05). Two groups prep-op serum IL-6, IL-10, cTnI, CRP, WBC levels had no significant difference (P> 0.05), all were in the normal range but post-op were significant higher than prep-op ( P <0.05). Compared with the control group, the decline of the serum IL-6, cTnI, CRP and WBC of the study group were sooner and more pronounced, but the decline of the serum IL-10 were later . In the study group, ascites IL-6 levels at T3, T4, T5 were significant higher than plasma (P <0.05), but IL-10 levels at T2, T3 is significant lower than plasma (P <0. 05).Conclusions: In the management of the complex congenital heart disease ,early postoperative ascitic drainage can reduce cytokine levels and reduce systemic inflammatory response syndrome. At the same time, the skill .is benefit to recovery impaired myocardium and improve cardiac function.