常温下不停跳心内直视手术的临床研究(附499例报告)  

INTRACARDIAC DIRECT-VISION BEATING-HEART SURGERY UNDER NORMAL TEMPERATURE

作　　者：李镇[1] 邢西忠[1] 张秀辉[1] 张玉春[1] 瞿晓琨[1] 张凤伟[1] 王恩伟[1] 景昊[1] 

机构地区：[1]临沂医专附属临沂市人民医院,山东临沂276003

出　　处：《临沂医学专科学校学报》2005年第1期21-22,共2页Journal of Linyi Medical College

摘　　要：目的　探讨常温下不停跳心内直视手术的方法和效果。方法　对 4 99例心脏病患者采用了常温下心脏不停跳心内直视手术。常规建立体外循环 ,维持鼻咽温 35℃～ 37℃ ,阻断上、下腔静脉 ,并行循环下行心内畸形矫治。结果　早期死亡 4例 ,神经系统并发症 7例 ,其中 6例为一过性的。平均住院 14 .6d。随访 6月～ 6年 ,发生室间隔残余分流 5例 ,二尖瓣置换术后致三尖瓣关闭不全 1例 ,1例部分型心内膜垫缺损矫治 2年后因关闭不全行二尖瓣置换 ,其余均恢复良好。结论　常温下不停跳心内直视手术是一种接近生理状态下的手术方法 ,能最大限度地减少心肌缺血、缺氧损伤 ,避免再灌注心肌损伤并能缩短手术时间。ObjectiveTo explore a new method and its eff ec ts of performing intracardiac direct-vision beating heart surgery under normal temperature.Methods 499 cases underwent intracardiac direct-visi on beating-heart surgery with extracoporeal circulation instituted and the temp erature maintained at 35℃～37℃.The superior and inferior vena cava was clamped and intracardial correction was performed.Results The six-month to six-year follow-up survey showed that early death occurred in four cases.T ricuspid incomplete closure happened in 1 case.Mitral incomplete closure happene d two years after the correction of partial endocardial cushion defects.Other ca ses recovered quite well.Conclusion The intracardiac direct-visi on beating-heart surgery under normal temperature has proven to be quite effect ive and can decrease the extent of myocardial ischemia and anoxic injury and can avoid myocardial reperfusion injury.

关 键 词：常温 不停跳 心内直视手术 体外循环 

分 类 号：R654.1[医药卫生—外科学]