心脏直视手术脑部并发症的防治(附37例报告)  

Prevention and Management of Brain Complication in Open - heart Operation (Report of 37 Cases)

作　　者：于建华[1] 李守先[1] 李朝晖[1] 卢静[1] 张供[1] 王涛[1] 

机构地区：[1]济南山东医科大学附属医院心外科,2500012

出　　处：《心肺血管病杂志》1997年第3期205-207,共3页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：回顾1714例心脏直视手术中发生脑部并发症37例。发生率2．1％。其中死亡21例，死亡率56％。发病原因：大量空气栓塞、脑微气栓栓塞、脑栓塞、颅内出血、脑缺血损伤等。作者认为必须十分重视预防脑部并发症。一旦发生，镇静、抗抽搐、降温、脱水和应用激素是治疗的关键措施。上腔静脉逆行灌注是术中抢救主动脉内大量气栓应即刻采用的有效方法。高压氧舱对气体栓塞疗效肯定，同时可降低颅内压、减少脑细胞的坏死。Thirty seven cases of brain complication occurred in 1714 open-heart operations The morbiditywas 2. 1%, There were 21 deathes (56%) among these 37 patients. The causes of brain complication were massiveair embolism (5 cases), microbubbles of brain (11 cases), brain emboli (5 cases), cerebrobascular bleeding(3 cases) and ischemic injury of the brain (8 cases). The authors suggest that preventing the occurrence of braincomplication is very important. The key methods of management are sedation,control of convulsion, lowering bodytemperature, dehydration and glucocorticoid application. Retrograde perfusion of the superior vena cava is an effective method and should be used as soon as massive arterial air embolism occurrs during operation Hyperbaric oxygenation is beneficical for air embolism.

关 键 词：脑气栓 颅内出血 并发症 高压氧 心脏直视术 

分 类 号：R654.2[医药卫生—外科学]