不停跳冠脉搭桥术中改心肺转流六例临床分析  

Clinical analysis of the patients undergoing coronary artery bypass grafting under urgent cardiopulmonary bypass

作　　者：王玉华[1] 李旭东[1] 王洪斌[1] 刘志勇[1] 

机构地区：[1]东南大学附属中大医院胸心外科,南京210009

出　　处：《江苏医药》2005年第10期752-753,共2页Jiangsu Medical Journal

摘　　要：目的对1999～2004年110例拟行非体外循环下冠脉搭桥手术(OPCAB)的患者中,6例术中改用心肺转流(CPB)行冠脉搭桥手术(ON-CAB)进行临床分析.方法采用中度低温CPB,自制高钾冷-温血停博液顺灌.结果 CPB时间(146.0±101.25) min,平均阻断时间(65.67±25.05) min.4例患者顺利脱机,2例在主动脉内球囊反搏(IABP)辅助下脱机;其中1例术后1天死于心衰,其余均顺利出院.结论严格掌握OPCAB手术适应证,必要时尽快建立CPB能够发挥较好的疗效.循环不稳的情况,应及时应用IABP.OPCAB不能取代ON-CAB.Objective To analyze the clinical materials from 6 patients underwent coronary artery bypass grafting （CAB） under urgent cardiopulmonary bypass （CPB）, who were schedullarly operated for CAB without CPB （OPCAB） in 110 cases. Methods CPB was established urgently with moderate hypothermia and hyperkalemic myocardioplegia. Results CPB time was （146.0 ± 101.3） min, and the time of aorta cross clamp was （65.7 ± 25.1） min. Weaning of CPB was in time in 4 cases, and intraaortic balloon pump IABP was given in 2 patients. One patient died from cardiac failure postoperatively. Conclusion Indications for OPCAB should be selected properly and CPB should be established in time if necessary. IABP is used in case of unstable circulation. OPCAB is not a substitute for On-pump CAB.

关 键 词：冠脉搭桥术 心肺转流 临床分析 不停跳冠脉搭桥 术中 主动脉内球囊反搏 冠脉搭桥手术 非体外循环下 OPCAB 阻断时间 

分 类 号：R654.2[医药卫生—外科学] R719.8[医药卫生—临床医学]