深低温、停循环、经右锁骨下动脉脑灌注在主动脉弓重建术中的应用(附11例报告)  

Application of antegrade selected cerebral perfusionvia the right subclavian artery during DHCAin aortic arch surgery

作　　者：杨苏民[1] 徐平[1] 曹倩[1] 

机构地区：[1]青岛大学医学院附属医院,山东青岛266003

出　　处：《山东医药》2003年第6期1-3,共3页Shandong Medical Journal

摘　　要：对 11例累及主动脉弓的主动脉瘤患者行主动脉弓重建术。术中采用深低温、停循环、经右锁骨下动脉插管持续选择性脑灌注技术行脑保护 ;监测颈内静脉或脑氧饱和度 ,脑灌注流量为 5～ 10 ml/ ( kg· min)。结果手术中心肌阻断时间 43～ 171分钟 ,平均 ( 92 .42± 46.47)分钟 ;体外循环时间 91～ 2 49分钟 ,平均 ( 13 4.12± 3 2 .49)分钟 ;最低鼻咽温 17.2℃ ;最长脑部低流量灌注时间 78分钟 ,平均 ( 2 9.2 6± 2 7.41)分钟。1例术后 9小时清醒 ,10例术后 5小时内清醒。全组体外循环过程顺利 ,均无神经系统并发症。认为本技术行脑保护操作简单、安全。patients with aortic dissections or aneurysms involving the aortic arch underwent surgical treatment using the selected cerebral perfusion via the right subclavian artery during deep hypothermic circulatory arrest for cerebral protection.The concomitantly arterial flow was from 5 to 10 ml/(kg·min).Through the period of selective cerebral perfusion,transcranial oxygen saturation was monitered. In all cases,neurologic complication had not happened.Mean times were(92.42±46.47)minutes (43~171) for aortic cross clamping and (134.12±32.49)minutes(91~249)for Cardi pulmonary bypass(CPB).The lowest systemic hypothermia was 17.2℃.Maximal systemic circulatory arrest time was 78 minutes.No patients died. This suggests that the technique of selected antegrade cerebral perfusion via the right subclavian artery during deep hypothermic circulatory arrest for cerebral protection appears safety and effection.

关 键 词：右锁骨下动脉插管 选择性脑灌注 深低温停循环 主动脉弓重建 

分 类 号：R654.3[医药卫生—外科学]