上腔静脉逆行灌注治疗体外循环中主动脉大量气栓  

Retrograde Perfusion through Superior Vena Cava in the Management of Massive Air Accumulation in the Aorta in Cardiopulmonary Bypass.

作　　者：宣伟光[1] 王刃[1] 姜晏波[1] 

机构地区：[1]大连市中心医院胸心外科

出　　处：《心肺血管病杂志》1995年第3期145-146,共2页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：本文报告２例动脉导管未闭患儿在体外循环下经肺动脉闭合导管的手术中，发生主动脉内大量气栓。当即使用了上腔静脉逆行灌注技术，自主动脉内排出大量气体。这２例的逆灌压力均达到６．７ｋＰａ（５０ｍｍＨｇ），高于文献中报告的压力。一例有术后清醒－昏迷－再清醒而后康复的过程，另一例按时清醒，顺利康复。２例均未遗留神经系统后遗症，分别随访５年和４个月，智力发育正常。作者认为，上腔静脉逆行灌注救治体外循环期间主动脉内大量气栓确实有效；逆灌压力似可达６．７ｋＰａ（５０ｍｍＨｇ）。Massive aortic air accumulation occurred in 2 undergoing closure of PDA through pulmonary artery under cardiopulmonary bypass.Retrograde perfusion through superior vena cava was performed immediately. Large volume of air was removed from the ascending aorta.The retrograde perfusion pressure reached 50mmHg which was higher than the pressure used for the same purpose by other authors reported in literature.One patient went through the course:consciousness-coma-consciousness.The other patient was awake on time and recovered smoothly.There was no neurological sequelae in either patients.They were followed up for 5 years and 4 months respectively.Their growth rate and intelligence were normal.The authors suggest that the superior vena cava retrogrde perfusion is beneficial for removal of the massive aortic air embolism which may occur during CPB and the perfusion pressure should be as high as 6.7kpa(50 mmHg).

关 键 词：体外循环 主动脉气栓 上腔静脉 逆行灌注 

分 类 号：R654.1[医药卫生—外科学]