主动脉弓部手术脑保护的临床研究现状  

Clinical research progress of brain protection in aortic arch surgery

作　　者：张赫 薛云星[3] 王东进[1,2] Zhang He;Xue Yunxing;Wang Dongjin(Graduate School of Peking Union Medical College,Beijing 100730,Chinese Academy of Medical Science,Beijing 100730,China;Department of Cardiac and Thoracic Surgery,Nanjing Drum Tower Hospital,Nanjing 210008 China;Nanjing Medical University Drum Tower Clinical Medical College,Nanjing 210008,China)

机构地区：[1]中国医学科学院北京协和医学院研究生院,北京100730 [2]南京鼓楼医院心胸外科,南京市210008 [3]南京医科大学鼓楼临床医学院,南京市210008

出　　处：《中华解剖与临床杂志》2020年第6期705-708,共4页Chinese Journal of Anatomy and Clinics

摘　　要：目的总结主动脉弓部手术中停循环温度及脑灌注方式的临床研究现状。方法以"主动脉" "主动脉弓" "脑保护" "脑灌注"和"aorta" "aortic arch" "brain protection" "cerebral perfusion"等为中英文关键词,在中国知网、万方数据库、PubMed、SinoMed等中英文数据库中检索2000年1月—2020年1月相关文献,按纳入排除标准最终纳入42篇,其中包括3篇中文文献和39篇英文文献。对主动脉弓部手术脑保护措施中停循环温度和灌注方式的临床研究成果进行总结。结果深低温和顺行脑灌注是目前临床主动脉弓部手术中应用较普遍的脑保护措施,具有良好的脑保护效果;同时,众多研究显示中低温和逆行脑灌注同样安全、有效。结论低温联合灌注保护策略正逐渐成为主动脉弓部手术中脑保护策略的主流形式,但对于温度、灌注方式等的选择仍有待进一步深入研究。ObjectiveTo summarize the findings of clinical studies on circulatory arrest temperature and cerebral perfusion mode in aortic arch surgery.MethodsA search of English and Chinese databases, such as PubMed, SinoMed, CNKI, and Wanfang, was conducted using the keywords "aorta" "aortic arch" "brain protection" "cerebral perfusion" and "主动脉" "主动脉弓" "脑保护" "脑灌注" to obtain literature related to the circulatory arrest temperature and perfusion mode in cerebral protective measures of aortic arch surgery published from January 2000 to January 2020. After reviewing these articles on the basis of the established inclusion and exclusion criteria, a total of 42 published reports, including 3 in Chinese and 39 in English, were finally included in the analysis.ResultsDeep hypothermia and antegrade cerebral perfusion were the most effective brain protective measures in clinical aortic arch surgery. Many studies showed that moderate hypothermia and retrograde cerebral perfusion are equally safe and effective.ConclusionsHypothermia combined with perfusion is gradually becoming the main brain protective strategy in aortic arch surgery. However, the choice of temperature and perfusion mode requires further study.

关 键 词：主动脉 胸 主动脉弓部手术 脑保护 脑灌注 停循环 深低温诱导 

分 类 号：R654.3[医药卫生—外科学]