体外循环在胸外科手术中的应用  

Application of extracorporeal circulation in thoracic surgery

作　　者：马丽娟[1] 郭庆凤[1] 崔建[1] 蒋树林[2] 农造莉[1] 

机构地区：[1]哈尔滨医科大学附属第四医院心胸外科,哈尔滨150001 [2]哈尔滨医科大学附属第二医院心外科

出　　处：《中国体外循环杂志》2010年第2期106-108,共3页Chinese Journal of Extracorporeal Circulation

摘　　要：目的总结在胸外科手术中应用体外循环(ECC)配合完成手术的方法及经验。方法 2005年2月至2010年2月共15例胸外科患者应用ECC配合完成手术,气管肿瘤8例,纵隔巨大肿瘤3例,肺癌侵及血管4例。ECC方式:股动脉/股静脉插管5例,股动脉/右心房插管7例,升主动脉/右心房(或腔静脉)插管3例。结果死亡2例(13.3%):肺癌侵及血管行右全肺切除+上腔静脉置换术1例;纵隔巨大肿瘤压迫上腔静脉行肿瘤切除+上腔静脉置换术1例,术后均因广泛渗血、多器官衰竭死亡。术中股动脉/股静脉建立ECC失败1例。其余12例均在ECC配合下顺利完成疾病根治手术,获得成功,无1例ECC相关并发症发生,均康复出院。随访5年生存率达83.3%。结论 ECC是一种安全有效的治疗支持技术,不仅能够广泛应用于心脏大血管手术,也可应用于胸外科的气管肿瘤、纵隔巨大肿瘤、肺癌侵及血管等危重患者手术中。OBJECTIVE To review the method and the experiences of extracorporeal circulation（ECC） in general thoracic surgery.METHODS 15 patients received thoracic surgery with ECC from February 2005 to February 2010,tracheal tumors（n=8）,large mediastinal tumor（n=3）,and lung cancer invasive vessel（n=4）.Mode of ECC：The ECC for 5 patients was achieved with femoral arterial and femoral venous cannulation,for 7 patients with femoral arterial,right atrium cannulation and 3 patients with ascending aorta,right atrium（or vena cava） cannulation.RESULTS Two patients（13.3%） died due to wide hemorrhage and multi-organ failure.One of them with lung cancer invasive vessel underwent right lung resection and superior vena cava（SVC） replacement.The other one with large mediastinal tumor oppress SVC underwent tumor resection and SVC replacement.1 case was failure to set up ECC with femoral arterial,femoral venous cannulation.The others（n=12） were all succeed in surgery with ECC,no complication occurred and all rehabilitation discharge.Five-year survival rate reached 83.3%.CONCLUSION ECC is a safe and efficient support technology in treatment.It is able to use not only in cardio-vascular surgery but also in general thoracic surgery for severe patients include tracheal tumor,larger mediastinal tumor,lung cancer invasive vessel and so on.

关 键 词：体外循环 胸外科 危重病患者 

分 类 号：R654.1[医药卫生—外科学]