胸主动脉瘤手术体外循环管理  

Management of cardiopulmonary bypass in patients undergoing operation of thoracic aneurysm

作　　者：叶晓青[1] 黄小蝶[1] 王辉[1] 张莉[1] 

机构地区：[1]深圳市孙逸仙心血管医院麻醉科,广东深圳518020

出　　处：《中国基层医药》2005年第8期1013-1015,共3页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的总结我院1993年8月至2004年5月29例胸主动脉瘤手术体外循环(CPB)经验。方法29例胸主动脉瘤患者,实施Bentall’s手术、主动脉次全弓及全弓置换术及升或胸降主动脉人工血管置换术。根据术式分别采用常规中低温CPB,中、深低温停循环加选择性脑灌注,选择性脑灌注加下半身灌注、部分股股转流等灌注方法。结果平均CPB时间(179·8±78·1)min。并发症以出血和感染为主。早期死亡2例,晚期死亡4例。死亡率20·7%。结论正确选择CPB方法及良好的CPB管理是胸主动脉瘤手术成功的保障。Objective To summarize the experience of the cardiopulmonary bypass of thoracic aneurysm operations in 29 cases from August 1993 to May 2004. Methods 29 patients underwent Bentall＇ s procedure, aortic hemiarch and total arch grafting,ascending aortic grafting and decending aortic grafting. The selection of perfusion techniques was based on surgical procedures. Patterns of CPB included moderate hypothermic CPB, moderate or deep hypothermic circulatory arrest with selective cerebral perfusion（SCP）,SCP with distal aortic perfusion and femoralfemoral partial CPB. Results Time of CPB was （ 179.8 ± 78.1 ） min. Bleeding and infection were major complications. The overall postoperative mortality was 20.7 % . Conclusion Selecting proper methods of CPB and excellent management of CPB are the key factors to success in thoracic aneurysm surgery.

关 键 词：主动脉瘤 胸 体外循环 血液灌注 主动脉瘤手术 体外循环管理 胸主动脉瘤 人工血管置换术 选择性脑灌注 BENTALL 深低温停循环 

分 类 号：R654[医药卫生—外科学]