主动脉弓部手术围手术期的脑保护  

Brain protection in perioperative period of aortic arch surgery

作　　者：唐一鹏 白云鹏[1] 陈庆良 TANG Yi-peng;BAI Yun-peng;CHEN Qing-liang(Department of Cardiovascular Surgery,Tianjin Institute of Cardiovascular Disease,Tianjin Key Laboratory of Cardiovascular Emergency and Critical Care,Chest Hospital,Tianjin University,Tianjin 300222,China)

机构地区：[1]天津大学胸科医院心血管外科天津市心血管病研究所、天津市心血管急危重症重点实验室,300222

出　　处：《中国现代神经疾病杂志》2024年第1期32-38,共7页Chinese Journal of Contemporary Neurology and Neurosurgery

基　　金：天津市医学重点学科(专科)建设项目(项目编号:TJYXZDXK-042A);天津市科技计划项目(项目编号:22JCYBJC01430);天津市科技计划项目(项目编号:22JCQNJC01040)。

摘　　要：体外循环和停循环下维持最佳脑灌注是主动脉弓部手术中脑保护的基础。脑保护策略包括低温、脑灌注、药物治疗和血气管理,已应用于临床,但最佳策略仍难确定。主动脉弓部手术中脑保护的临床结局在很大程度上取决于脑温、停循环时间和脑灌注类型,最佳的脑保护策略应是在全面脑监测的基础上进行个体化治疗,有效减少脑损伤。本文总结体外循环下主动脉弓部手术脑监测与管理方法或指标以及围手术期脑保护策略,以指导主动脉弓部手术中脑保护的临床实践。Maintaining optimal cerebral perfusion during cardiopulmonary bypass and circulatory arrest is basis of intraoperative management of aortic arch surgery.Various cerebral protection techniques including hypothermia,cerebral perfusion,drug protection and blood gas management have been used in the clinic,but the optimal strategy remains difficult to determine.The clinical outcome of cerebral protection in aortic arch surgery largely depends on brain temperature,circulatory arrest time and cerebral perfusion at the time of circulatory arrest.The optimal brain protection strategy should be individualized treatment on the basis of comprehensive brain monitoring,so as to effectively reduce the occurrence of brain injury.This article summarizes the means or indicators of brain monitoring and management during cardiopulmonary bypass in aortic arch surgery,as well as perioperative brain protection strategies,in order to guide the clinical practice of intraoperative brain protection in aortic arch surgery.

关 键 词：主动脉 胸 体外循环 心血管外科手术 围手术期 综述 

分 类 号：R654.3[医药卫生—外科学]