先天性主动脉弓病变合并异常锁骨下动脉起源患者围体外循环期管理  

Cardiopulmonary bypass management in patients with congenital aortic arch disease combined with abnormal subclavian artery

作　　者：王会颖 刘晋萍 李守军 柏利婷 刘佳 Wang Huiying;Liu Jinping;Li Shoujun;Bai Liting;Liu Jia(Department of Cardiopulmonary bypass,Fuwai Hospital,National Center for Cardiovascular Disease,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100037,China)

机构地区：[1]中国医学科学院、北京协和医学院、国家心血管病中心、阜外医院体外循环中心,北京100037 [2]中国医学科学院、北京协和医学院、国家心血管病中心、阜外医院小儿外科中心,北京100037 [3]首都医科大学附属友谊医院麻醉科,北京100050

出　　处：《中国体外循环杂志》2025年第1期17-22,共6页Chinese Journal of Extracorporeal Circulation

基　　金：中国医学科学院医学与健康科技创新工程项目(2024-12M-C&T-B-045)。

摘　　要：目的探讨主动脉弓部病变合并异常锁骨下动脉起源患儿的围术期监测和体外循环管理特点。方法回顾本院4例主动脉弓部病变同时接受异常锁骨下动脉畸形矫治的患儿资料及体外循环管理要点。结果4例患儿通过术中血压监测联合局部组织氧饱和度监测,以保证充足的脑灌注及脑供需平衡,术后均无中枢神经系统并发症,无院内死亡,恢复良好。结论针对此类复杂畸形患儿,术前熟悉患儿的解剖,与外科和麻醉医生做好沟通,完善术中监测,特别是脑氧饱和度的监测至关重要。Objective To explore the perioperative monitoring and cardiopulmonary bypass management characteristics of patients with aortic arch lesions and abnormal subclavian arteries.Methods The clinical data of four cases in our hospital who underwent surgical correction of aortic arch diseases complicated with abnormal subclavian arteries were reviewed,as well as the key points of cardiopulmonary bypass management.Results The four children had no central nervous system complications,no hospital deaths,and experienced a good recovery after intraoperative blood pressure monitoring combined with local oxygen saturation monitoring to ensure adequate cerebral perfusion and balance of cerebral supply and demand.Conclusion For children with such complex malformations,it is important to be familiar with the anatomy before surgery,communicate with surgeons and anesthesiologists,and improve intraoperative monitoring,especially the monitoring of cerebral oxygen saturation.

关 键 词：主动脉弓病变 迷走锁骨下动脉 体外循环 区域性脑灌注 局部组织氧饱和度 

分 类 号：R726.5[医药卫生—儿科]