成人降主动脉置换术中三种体外循环灌注技术的应用  

Application of Three Cardiopulmonary Bypass Perfusion Techniques in Adult Descending Aorta Replacement

作　　者：赵赟[1] 胡克俭[1] 程玥[1] 罗海燕[1] 彭润生[1] 陈佳莉[1] 施杨[1] 戚晓敏[1] 王春生[1] 

机构地区：[1]复旦大学附属中山医院心外科,上海200032

出　　处：《生物医学工程学进展》2011年第1期29-32,共4页Progress in Biomedical Engineering

摘　　要：目的总结分析成人降主动脉置换术中各种体外循环灌注的技术特点和管理方法。方法 2006年1月至2009年12月,共有60例患者行降主动脉置换手术。按体外循环灌注技术类型分为3组:左心转流组4例,股动静脉转流组37例,上下半身分别灌注组19例。三组预充均采用勃脉力A和胶体,常规加入白蛋白和激素,监测混合静脉氧饱和度和血细胞压积,积极应用超滤技术和自体血液回收技术。结果术中转流平稳,血流动力学稳定,监测指标均在正常范围,仅出现9例并发症(截瘫、偏瘫、谵妄、苏醒延迟、低氧血症)。结论成人降主动脉置换术中根据不同的手术方式,正确选择和熟练应用相应的灌注技术是决定手术成功的重要因素。Objective To summarize the characteristic and management of cardiopulmonary bypass（CPB） perfusion techniques in adult descending aorta replacement.Methods From January 2006 to December 2009,60 patients underwent descending aorta replacement in our hospital.According to the difference of CPB perfusion techniques,they were divided into three groups： left-sided heart bypass（LHB） group（group A）,femoral artery-venous bypass group（group B）,upper and lower body separate perfusion group（group C,）.All patients were given plasmalyte-a,colloid,album and sou-medrol in CPB prime.Ultrafiltration technique and cell saver were actively used during CPB.Results It was well-balanced and stably in CPB.Only nine patients had complications,including paraplegia,hemiplegia,phrenitis,delayed recovery and hyoxemia.Conclution The techniques of left-sided heart bypass,femoral artery-venous bypass and upper and lower body separate perfusion could be applied in adult descending aorta replacement.According to the different surgical approach,to choose the correct perfusion technique was the key of surgical operation success.

关 键 词：体外循环 降主动脉置换 

分 类 号：R654.2[医药卫生—外科学]