胸主动脉瘤手术的体外循环管理  

Management of Cardiopulmonary Bypass During Operations on Thoracic Aortic Aneurysm

作　　者：鲍玫[1] 郭斌[1] 李晓辉[1] 李萍[1] 

机构地区：[1]石家庄白求恩国际和平医院胸心外科,河北石家庄050082

出　　处：《中国体外循环杂志》2005年第2期103-104,共2页Chinese Journal of Extracorporeal Circulation

摘　　要：目的探讨不同部位胸主动脉瘤手术的体外循环方法。方法单纯升主动脉人造血管置换、升主动脉人造血管置换+主动脉瓣膜置换的病人采用股动脉———二极管插管,中低温、中等流量体外循环方法。Bentall手术+全弓置换手术的病人选择股动脉及上、下腔静脉插管,深低温停循环并上腔静脉逆行灌注的脑保护方法。1例选择股动脉及右房二极管插管,中低温选择性顺行脑灌注的脑保护方法。结果一例升主动脉人造血管置换+主动脉瓣膜置换的病人于术后9天死于多脏器功能衰竭,其余病人均顺利康复,无神经系统并发症。结论升主动脉近端胸主动脉瘤手术可采用常规体外循环方法,主动脉弓部手术采用两种方法均可获得良好的脑保护效果。OBJECTIVE The purpose of this study is to seek perfusion methods in different type of thoracic aortic aneurysm. METHODS The femoral artery and two -stage cannulation was applied to ascending aorta replacement or ascending aorta with aortic valve replacement, while the moderate hypothermia with aortic cross-clamping were used. The patients who underwent total arch replacement were protected brain by one of two methods: deep hypothermic circulatory arrest with retrograde cerebral perfusion or moderate hypothermia with selective antegrade cerebral perfusion.RESULTS The patients had an excellent outcome but one died of multi-organs failure on 9th day after underwent ascending aorta with aortic valve replacement. CONCLUSION Our experience shows that both methods are optimal technique of cerebral protection during operations on aortic arch.

关 键 词：胸主动脉瘤 体外循环 

分 类 号：R654.3[医药卫生—外科学]