人工心脏瓣膜再次置换手术的体外循环管理  

MANAGEMENT OF CARDIOPULMONARY BYPASS IN THE SECOND HEART VALVE REPLACEMENT

作　　者：李美霞[1] 田毅[1] 符白嫩[1] 侯春燕[1] 

机构地区：[1]海南省海口市人民医院麻醉科,海口570208

出　　处：《现代预防医学》2011年第19期4025-4026,共2页Modern Preventive Medicine

基　　金：海口市科技计划项目(2007-0000058)

摘　　要：[目的]回顾总结30例再次心脏瓣膜置换手术的体外循环(CPB)管理和方法。[方法]对2005年1月～2010年1月的30例再次心脏瓣膜置换手术患者,术前进行全面评估,充分准备,术中采用适宜的插管部位,自体血液回收,中一高流量,维持平均动脉压(MAP)50～80mmHg。[结果]二尖瓣或主动脉瓣单瓣置换16例;二尖瓣+主动脉瓣置换7例;二尖瓣+主动脉瓣+三尖瓣置换4例;三尖瓣置换3例,无手术死亡,术后死亡2例。[结论]再次心脏瓣膜置换手术中,术前充分准备,选择适当插管部位,术中加强血液保护、心肌保护,采取综合措施是保证CPB成功的关键。To conclude the management experience of cardiopulmonary bypass in the surgery of second heart valve replacement.[Methods]Collected 30 patients undergoing the second heart valve replacement from January 2005 to January 2010,we took overall evaluation and thoroughly preparation before the operation,catheter at suitable site,autotransfusion,middle-high rate of flow and maintained MAP between 50-80mmHg.[Results]There was no death cases during operation of all the patients,of which 16 patients undergoing single mitral valve or aortic valve replacement,7 patients undergoing both mitral valve and aortic valve replacement,4 patients undergoing mitral valve,aortic valve and tricuspid valve replacement,3 patients undergoing tricuspid valve replacement,but 2 deaths after operation.[Conclusion]During the second heart valve replacement surgery,the preparation before operation,suitable catheter site,intensive blood protection and myocardium protection and taking combined intervention are the keys to guarantee the success of cardiopulmonary bypass.

关 键 词：瓣膜置换 二次手术 体外循环 

分 类 号：R654.1[医药卫生—外科学]