先天性心脏病心脏停跳和不停跳下心内直视手术的临床分析  

Clinical analysis on open heart operation of congenital heart disease with beating heart and heart arrest

作　　者：陈林[1] 肖颖彬[1] 王学峰[1] 钟前进[1] 陈柏成[1] 陈进劲[1] 刘兵[1] 曾祥君[1] 

机构地区：[1]第三军医大学附属新桥医院心血管外科,重庆400037

出　　处：《第三军医大学学报》2000年第11期1056-1058,共3页Journal of Third Military Medical University

摘　　要：目的　对比分析心脏停跳和不停跳心内直视手术治疗先天性心脏病心内畸形的疗效。方法　5 5 8例患者分别采用心脏停跳手术 2 31例 ,不停跳手术 32 7例。心脏不停跳心内直视手术仍常规建立体外循环 ,置左心房引流管 ,降温至 (32± 1)℃并维持 ,仅阻断上下腔静脉 ,不阻断主动脉 ,维持灌注压在 8kPa左右 ,心脏跳动下进行畸形矫正 ,方法同停跳下手术。结果　不停跳组早期死亡 7例 (死亡率 2 .14 % ) ,停跳组早期死亡 5例 (死亡率 2 .17% ) ,其余均痊愈出院 ,随访 3～ 2 3月 ,恢复良好。结论　心脏不停跳心内直视手术 ,是一种有效的心肌保护方法 ,并可简化操作 。Objective To compared the efficiency of beating heart and blood cardioplegic arrest in open heart operation of congenital heart diseases. Methods Among all 558 cases, 231 were accepted the operation under blood cardiaplegic heart arrest, while 327 were under beating heart. In beating heart group, only the two venae cavae were clamped, the perfusion of cannulation of aorta was kept at (32±1)℃ of the nasopharyngeal temperature and its pressure was kept at 8 kPa during the cardiac surgical procedure. The intracardiac malformation was repaired as blood cardioplegic arrest group. Results There were 7 cases of surgical death (2.14%) in beating heart group, and 5 (2.17%) died in arrest group. The others were cured and recovered well during the 3-23 months follow up. Conclusion The open heart operation in beating heart is a new good way for myocardial protection, which can simplify the operative procedure and shorten the mean cardiopulmonary bypass time as compared with that in arrest heart .

关 键 词：心脏缺损 先天性 体外循环 心脏外科手术 

分 类 号：R654.2[医药卫生—外科学]