室间隔缺损合并肺动脉高压的体外循环管理  

The extracorporeal circulation management in ventricular septal defect and pulmonary hypertension patients

作　　者：潘绪[1] 汤楚中[1] 李寒[1] 孙文婷[1] 解水本[1] 赵哲[1] 迟海涛[1] 

机构地区：[1]海军总医院心脏中心,北京100048

出　　处：《北京医学》2013年第7期499-501,共3页Beijing Medical Journal

摘　　要：目的总结室间隔缺损合并肺动脉高压的患者心内直视修补术中体外循环的管理。方法选择2005年10月至2010年12月我院收治的室间隔缺损合并肺动脉高压患者65例,经诊断性治疗后54例患者在体外循环下行室间隔缺损修补术。结果体外循环时间26～68min,平均(46±12)min;主动脉阻断时间15～38min,平均(26±8)min。手术死亡1例(1.8%),术后第5天死于低心排出量综合征。结论对于室间隔缺损合并肺动脉高压患者,掌握好手术适应证、术中体外循环配合注重心肌保护、肺保护、酸碱和电解质平衡的纠正、扩血管药物以及超滤技术的应用,直接影响手术疗效。Objective To Summarize the extracorporeal circulation management of ventricular septal defect with pulmonary hypertension.Methods From October 2005 to December 2012,65 patients with ventricular septal defect with pulmonary hypertension were admitted in the hospital.Fifty-four cases of ventricular prothesis were performed under extracorporeal circulation conventionality.Results The duration of extracorporeal circulation was from 26 minutes to 68 minutes,aorta crass clamping time ranged from 15 to 38 minutes.One patient died.Conclusion For patients with ventricular septal defect with pulmonary hypertension,appropriate time for operation,myocardial preservation,pulmonary protection,correction of acid-base imbalance,prompt application for ultrafiltration and vasodilatoin are important factors for successful extracorporeal circulation.

关 键 词：室间隔缺损 肺动脉高压 体外循环 

分 类 号：R654.1[医药卫生—外科学]