主动脉弓部手术的体外循环管理  

The cardiopulmonary bypass management-of aortic arch surgery

作　　者：刘建华[1] 刘海霞[1] 孙建全[1] 李爱枝[1] 刘洋[1] 韩冰[1] 

机构地区：[1]河南省胸科医院体外循环科,河南省郑州450008

出　　处：《中国基层医药》2008年第2期229-230,共2页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探讨主动脉弓部手术体外循环管理的有效性与安全性。方法42例均采用深低温停循环结合选择性脑灌注（DHCA＋SCP），用单泵双管。28例通过股动脉及右锁骨下动脉插管建立体外循环及选择性脑灌注，14例停循环时通过1～3支气囊导尿管经头臂干血管行脑灌注。结果全组患者1例术后不醒，1周后放弃治疗出院；1例术后第7天右无名动脉闭塞，脑梗死昏迷；其余无任何体外循环相关的手术并发症，痊愈出院。结论主动脉弓部手术采用DHCA＋SCP的方法是安全有效的。Objective To review and sum up cardiopulmonary bypass（CPB） management for aortic arch surgery. Methods All of the 42 patients were scheduled for aortic arch surgery with deep hypothermic circulatory arrest（DHCA） plus selective cerebral perfusion（SCP） techniques. The technique of double arterial lines with single pump head was employed for all of the patients, too. An arterial perfusion cannula was inserted into the femoral artery for cardiopulmonary bypass and the right subclavian artery was also cannulated for selective cerebral perfusion for 28 patients. 1- 3 aerocyst catheter was/were inserted into brachiocephalic trunk for cerebral perfusion when circulation was arrested for the other 14 patients. Results One patient could not regain consciousness after operation and was discharged a week after operation for whose relatives gave up the treatment. One patient＇s innominate artery was occluded on the seventh day after operation and who suffered with a coma caused by cerebral infarction. The other patients experienced an uneventful recovery and discharge without any one complication relating to cardiopulmonary bypass. Conclusion The technique of DHCA plus SCP is safe and effective in the surgery of aortic arch.

关 键 词：体外循环 主动脉 胸 心脏外科手术 脑 

分 类 号：R654.1[医药卫生—外科学] R657.4[医药卫生—临床医学]