心脏停跳和不停跳瓣膜置换术体外循环效果比较  

The Comparison in Management of Cardiopulmonary Bypass with Beating or Arresting Hearts for Valve Replacement

作　　者：刘梅[1] 肖颖彬[1] 陈林[1] 王学峰[1] 彭莉[1] 胡卫[1] 王惠春[1] 陈柏成[1] 陈劲进[1] 廖晓娅 

机构地区：[1]第三军医大学附属新桥医院心血管外科,400037

出　　处：《重庆医学》2000年第3期198-200,共3页Chongqing medicine

摘　　要：目的　探讨心脏停跳（ＡＨ）和不停跳（ＢＨ）瓣膜置换术（ＶＲ）体外循环（ＣＲＢ）管理技术的特点。方法　观察２０１例ＶＲ患者，其中ＡＨ９０例，ＢＨ１１１例。比较两组在ＣＲＢ期间及术后相关指标的改变。结果　两组相比，ＢＨ组转流时间和阻断时间较短，使用库血例数和库血用量、钾和碳酸氢钠用量、术中失血量等较少（ Ｐ＜ ０． ０５） ；术后血管扩张剂使用率较高（ Ｐ＜ ０． ０５）。结论心脏不停跳瓣膜置换手术在ＣＰＢ管理方面优于心脏停跳心内直视手术。Objective:To explore the differtnce in the management of cardiopulmonary bypass(CPB) while beating or arresting heart in valve re- placements.Methods:201 cases of valve replacenents were subjected into groups with beating - heart(Group BH, n = 111) or arresting - heart (Group AH, n=90 ). The preoperative states and postoperative courses of the patients were compared.Blood gas, serum electrolytes ,urine output during CPB were recorded and analyzed statistically.Results:The operative mortality was 1.8% in Group BH, and 4. 2% in Group AH. There was no bypass - related death in both groups.The amount of administration of potassium and sodium bicarbonate during CPB,and bankblood using in Group BH was much less, but the rate of vasorelaxant administration was higher than that in Group AH. conclusion: Cardiopulmonary bypass with beating - heart for valve replacement is safe and easier to manage.

关 键 词：体外循环 心脏停跳手术 心脏瓣膜置换术 

分 类 号：R654.2[医药卫生—外科学]