主动脉夹层术中心包大量积血回收导致膜肺氧合不良的原因分析及处理  

The causes and treatment for poor membrane oxygenation afterpericardial bloodrecoveryin aortic dissection surgery

作　　者：卢金峰[1] 张鲁英[1] 姜冠华[1] 梁家立[1] 

机构地区：[1]济南军区总医院心外科,济南250031

出　　处：《中国体外循环杂志》2015年第2期111-112,共2页Chinese Journal of Extracorporeal Circulation

摘　　要：目的分析导致膜肺氧合不良的原因并探讨相应的防范措施。方法回顾分析2013年1月至2014年6月期间10例主动脉夹层手术病例资料。体外循环(CPB)使用Medtronic Affinity NT集成CVR膜式氧合器,2例手术期间血液及积血直接回收至预充且肝素化的氧合器中,8例通过cell saver 5型血液回收机回收大量积血,CPB中将洗涤后的红细胞回收至氧合器。结果积血直接入氧合器2例发生氧合不良,余8例无氧合不良。结论胸腔及心包大量积血回收至氧合器可致氧合不良。血液回收机洗涤大量积血可避免氧合器氧合不良的发生。Objective To analyze the causes of poor oxygenation and to explore the appropriate precautions.Methods Ten-cases of repair of aortic dissection were recruited from January 2013 to June 2014.Results The pericardial blood collectionof 2 caseswere recovered during surgery through the pre-charged and heparinized Medtronic Affinity NT integrated CVR membrane oxygenatorand caused pooroxygenation. Blood Clots of eight cases were washed by cell saver 5 type. Packed red blood cells filtered out by CPBwere recovered to Medtronic Affinity NT integrated CVR membrane oxygenator. None had poor oxygenation.Conclusion Recovery ofblood from the pleural and pericardial cavitie can result in impaired oxygenationin the membrane oxygenator. which can be avoidedbywashing the blood in the cell saver.

关 键 词：氧合不良 主动脉夹层 膜式氧合器 

分 类 号：R654.3[医药卫生—外科学]