浅低温体外循环心脏不停跳心内直视术  

Open heart surgery on beating heart with mild hypothemia and cardiopulmonary bypass

作　　者：李强[1] 李朝先[1] 杨双强[1] 向小勇[1] 汪斌[1] 蒋迎九[1] 陈力[1] 

机构地区：[1]重庆医科大学附属第一医院胸心外科,400016

出　　处：《重庆医学》2002年第8期707-708,共2页Chongqing medicine

摘　　要：目的　总结 12 8例浅低温体外循环心脏不停跳心内直视术的临床应用经验 ,并对心肌保护、空气栓塞的防止进行探讨。方法　常规建立体外循环 ,并体循环 ,维持全身浅低温 3 2～ 3 3℃ ,心脏缓慢跳动 ,进行心内直视手术 ,术中应用无层级排气装置防止空气栓塞 ;行主动脉瓣替换 ,则钳夹阻断主动脉的同时 ,进行冠状静脉窦逆灌维持心脏血供。结果　全组病例无手术死亡 ,无空气栓塞、低心排综合征等并发症。结论　浅低温体外循环心脏不停跳心内直视术心肌保护效果好 ,手术安全可行 。Objective To summarize the clinical experience of open heart surgery on beating heart with mild hypothemia and cardiopulmonary bypass in 128 cases and to explore the related issues with myocardioprotective effect and prevention of air embolism. Methods Conventional cardiopulmonary bypass was established, the body temperature was maintained at 32～33℃, and intracardiac operations were performed on beating heart. Air embolism was avoided during operations through a special device. The aortic valve replacement was performed on beating heart under coronary sinus retrogate perfusion. Results There were no operative mortality, no air embolism and low cardiac output syndrom. Conclusion Results showed that the technique of open heart surgery on beating heart with mild hypathemia and cardiopulmonary hypass has an optimal myocardioprotective effect, it is safe and practicable, especially for severe cases.

关 键 词：浅低温 体外循环 心脏不停跳心内直视术 临床应用 

分 类 号：R654.1[医药卫生—外科学]