原位肝移植的静脉-静脉转流  

Venou venous bypass in orthotopic liver transplantation

作　　者：施丽萍[1] 郑树森[1] 陈英莲[1] 钱林锋[1] 黄东胜[1] 梁廷波[1] 王伟林[1] 

机构地区：[1]杭州浙江大学医学院附属第一医院,310003

出　　处：《中华器官移植杂志》2001年第3期134-136,共3页Chinese Journal of Organ Transplantation

摘　　要：目的　评价体外静脉 静脉转流技术对原位肝移植术中无肝期血流动力学、生化、体温和肾功能的影响。方法　 2 8例原位肝移植术中使用JostraRotaFlow离心泵、热交换器、边缘肝素化进行开放式静脉 静脉转流。结果　体外静脉 静脉转流时间 (136 .7± 6 0 .4)min ,灌注流量 0 .5～ 3 .5L/min ,动脉压维持在 (82 .3± 3 .3)mmHg ,中心静脉压维持在 (8.12± 4.0 5 )cmH2 O ,鼻咽温为 (36 .8± 0 .47)℃ ,激活全血凝固时间为 2 80～ 32 0s,血液气体及生化指标基本正常 ,停止转流后血流动力学稳定 ;10例的肌酐及尿素氮均有下降。结论　采用离心泵、热交换器、边缘肝素化的体外静脉Objectives Evaluate the effect of venous venous bypass on hemodynamics, biochemistry and body temperature during orthotopic liver transplantation. Methods Venous venous bypass with Jostra RotaFlow centifugal pump, heat exchanger were used and partial heparinization performed in 28 cases undergoing allogenic orthotopic liver transplantation. Results The average duration of venous venous bypass was 87～398 min ( 136.7 min± 60.4 ?min), perfusion flow rate was 0.5 ～ 3.5 ?L/min, mean arterial pressure and CVP maintained at ( 82.3 ± 3.3 )?mmHg and ( 8.12 ± 4.05 )?cm?H 2O respectively, the average nasopharyngeal temperature and ACT maintained at ( 36.8 ± 0.47 )?℃ and 280～320?s respectively. The results of gas analysis and biochemical test were normal. Conclusions The use of the centrifugal pump and heat exchanger with partial heparinization in venous venous bypass can provide a good support to orthotopic liver transplantation.

关 键 词：体外循环 静脉-静脉转流 原位肝移植 

分 类 号：R657.3[医药卫生—外科学]