Stanford A型主动脉夹层中低温停循环手术安全温度研究  

Safe temperature of moderate hypothermic circulatory arrest in Stanford type A aortic dissection

作　　者：汪源[1] 周曼玲[1] 黄飞[1] 石平[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院心脏大血管外科,湖北武汉430030

出　　处：《中国医药导报》2017年第19期59-61,72,共4页China Medical Herald

基　　金：湖北省自然科学基金面上项目(2015CFB463)

摘　　要：目的探讨Stanford A型主动脉夹层中低温停循环手术的安全温度范围。方法收集2015年1月~2016年10月同济医院收治的Stanford A型主动脉夹层手术患者40例,随机分为低温度组(鼻咽温22~<24℃)与高温度组(鼻咽温24~26℃),每组各20例,在中度低温停循环结合单侧顺行性脑灌注下行手术治疗。观察两组病例的术中术后情况。结果低温组体外循环时间较高温组显著延长(P<0.01),主动脉阻断时间与停循环时间两组差异无统计学意义(P>0.05)。两组间TND(短暂性神经系统障碍)和PND(永久性神经障碍)差异无统计学意义(P>0.05);低温组ICU天数较高温组显著延长(P<0.05);住院死亡率及住院天数两组差异无统计学意义(P>0.05)。结论鼻咽温24~26℃是Stanford A型主动脉夹层中低温停循环手术合适的安全温度。Objective To explore the safe temperature range of the moderate hypothermic circulatory arrest surgery in Stanford type A aortic dissection. Methods From January 2015 to October 2016, in Tongji Hospital, 40 Stanford type A aortic dissection patients were divided into two groups by random number table, low temperature group （nasopharyngeal temperature 22-〈24℃） and high temperature group （nasopharyngeal temperature 24-26℃）, with 20 cases in each group, all patients were given surgery under moderate hypothermic circulatory arrest and Unilateral paraminic brain ir- rigation. The intraoperative and postoperative situation in the two groups was observed. Results The CPB time in the low temperature group was significantly more than that in the high temperature group （P 〈 0.01）, and there was no sta- tistically significant difference in the aortic clamping time and the arrest time between the two groups （P 〉 0.05）. There was no significant difference in TND and PND between the two groups （P 〉 0.05）. The ICU time in the low temperature group was significantly more than that in the high temperature group （P 〈 0.05）. There was no significant difference in the hospitalization time and inpatient mortality between the two groups （P 〉 0.05）. Conclusion 24-26℃ is a more safe nasopharyngeal temperature range in Stanford type A aortic dissection during moderate hypothermic circulatory arrest.

关 键 词：主动脉夹层 中低温停循环 脑保护 

分 类 号：R654.2[医药卫生—外科学]