高龄患者冠状动脉搭桥手术的体外循环管理  

Cardiopulmonary Bypass Management of Coronary Artery Bypass Surgery in the Aged Patients

作　　者：成惠玲[1] 吴红兵[2] 王志维[2] 张敏[2] 张遵严[2] 陈雪芬[2] 戴飞锋[2] 杨帆[1] 

机构地区：[1]湖北省黄石市中心医院胸心外科,黄石435002 [2]武汉大学人民医院心血管外科,武汉430060

出　　处：《中国现代手术学杂志》2013年第2期151-153,共3页Chinese Journal of Modern Operative Surgery

摘　　要：目的总结高龄患者行冠状动脉搭桥手术体外循环(cardiopulmonary bypass,CPB)管理的经验。方法行冠状动脉搭桥手术患者48例,其中70岁以上者28例(高龄组),70岁者20例(非高龄组),回顾性比较两组的CPB差异。结果高龄组患者术前更易合并糖尿病,术前HCT较低(P<0.05)。高龄组体外循环时间(135.6±17.3)min,升主动脉阻断时间(101.3±40.2)min,术后改良超滤10例,与非高龄组相比较,差异有显著性;高龄组应用库血预充占82.1%(23/28),明显高于非高龄组的25%(P<0.01),升主动脉开放后,高龄组自动复跳24例(85.7%),非老年组自动复跳17例(85%),两组比较无差异;但高龄组有3例停CPB后需IABP辅助脱机。结论高龄并非心脏手术CPB的禁忌症,根据其患病特点,合理地行CPB管理,可以为高龄患者成功地进行冠状动脉搭桥手术提供重要保证。Objective To summarize the cardiopulmonary bypass （CPB）management experiences in eld- erly patients over 70 years old underwent coronary artery bypass operation. Method It was retrospectively compared in 28 cases over 70 years old and 20 cases younger than 70 years. Results The elderly patients were more vulnerable to diabetes, and their pre-operative HCT was lower. In the elderly group, the CPB time was （135.6± 17.3） rain, the ascending aorta blocking time was （101.3 ±40.2） min, and both were significantly different from the younger group. There werel0 cases of the aged group underwent the modified ultrafiltration after operation, and the younger group was O（P = 0）. Conclusion It is helpful for the aged to the coronary artery bypass operation of the individualized CPB management.

关 键 词：冠状动脉分流术 体外循环 老年人 

分 类 号：R654.2[医药卫生—外科学]