浅低温体外循环不停跳瓣膜置换术800例临床分析  

Report on 800 cases of valve replacement under mild hypothermia with on-pump beating heart

作　　者：陈柏成[1] 肖颖彬[1] 陈林[1] 钟前进[1] 王学锋[1] 周骐[1] 易广兵[1] 

机构地区：[1]第三军医大学附属新桥医院心血管外科,重庆市400037

出　　处：《心血管康复医学杂志》2004年第4期345-348,共4页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:总结浅低温体外循环不停跳瓣膜置换术800例的临床经验,提高瓣膜疾病的外科治疗水平。方法:回顾性分析1997年11月至2003年5月期间,我科采用不停跳技术完成的800例瓣膜置换术的临床资料。结果:本组二尖瓣置换术(MVR)517例,主动脉瓣置换术(AVR)88例,双瓣膜置换术(DVR)195例。全组平均转流时间为109.38±40.64分钟,平均主动脉或上下腔静脉阻断时间77.87±27.99分钟,术后呼吸机辅助时间17.78±12.21小时。术后发生严重并发症5l例(6.38％)。术后早期死亡17例,手术早期死亡率2.13％。结论:浅低温体外循环不停跳技术应用于瓣膜置换术安全可靠,效果满意。综合序贯排气方法是浅低温不停跳技术成功的关键环节之一。Objective: To introduce the experiences of valve replacement under mild hypothermia on-pump beating heart and to improve the surgical treatment of valvular diseases. MethodS: From november 1997 to May 2003, 800 consecutive cases of valve replacement under beating heart were conducted at Xinqiao Hospital. The records of the patients who underwent valve replacement were reviewed retrospectively. Results: This cohort included 517 cases of mitrai valve replacements (MVR), 88 cases of aortic valve replacements (AVR), and 195 double valve replacements (DVR). Mean cardiopulmonary bypass time was 109. 38±40. 64 minutes, and mean cava cross clamp time was 77. 87±27.99 minutes. Mean mechanical ventilation time was 17. 78±12. 21 hours. Severe postoperative complications occurred in 51 cases(6. 38%). There were 17 cases of deaths during early postoperative stage, and the early mortality rate for VR was 2. 13%. Conclusion: Mild hypothermic with on-pump beating-heart technique offers a safe and practical surgical option and may yield excellent clinic results for the patients undergoing valve replacement surgery. The integrated sequenced de-airing procedure is the key technique of on-pump beating heart.

关 键 词：浅低温 体外循环 不停跳 瓣膜置换术 瓣膜疾病 外科治疗 心内直视手术 

分 类 号：R654.2[医药卫生—外科学]