浅低温心脏不停跳心内直视手术194例临床报告  

A clinical report of 194 cases for open heart surgery with beating heart

作　　者：李香伟[1] 林辉[1] 贺榜福[1] 温昭科[1] 叶宁[1] 梁胜景[1] 陆卫军[1] 卢昌超[1] 莫安胜[1] 

机构地区：[1]广西壮族自治区人民医院胸心外科,530021

出　　处：《广西医学》2003年第12期2373-2374,共2页Guangxi Medical Journal

基　　金：广西人事厅"2 0 0 1年度广西跨世纪十百千人才工程"项目 (合同号 :2 0 0 1 2 0 3);广西区卫生厅医药卫生计划课题 (合同号 :2 0 0 1 1 0 71 )

摘　　要：目的 :探讨心脏不停跳心内直视手术的临床意义和价值。方法 :并行循环 ,阻断上下腔静脉而不阻断升主动脉 ,不使用心脏停搏液 ;逆行灌注者 ,阻断升主动脉后经冠状静脉窦逆行持续灌注机器氧合血 ,鼻咽温维持在 33℃± 1℃ ,在心脏空跳条件下完成心内直视手术。结果 :心脏手术完毕即可停机 ,术后血液动力学平稳 ,多巴胺用量很少。低心排发生率 1 .0 % ,血尿发生率 3.8%。无 1例发生空气栓塞。早期死亡率 2 .5 % (5 / 1 94 )。结论 :心脏不停跳法是一种较接近生理状态的心肌保护方法 ,获得较理想的心肌保护和临床效果 。Objective:To study the clinical meaning and value of open heart surgery with beating heart Methods:As CPB,aortic root was not cross clamped and no cardioplegia solusion was used.Myocardium was perfused with oxygenated blood via aortic artery.When cross clamp needed,myocardium was retrogradely perfused via coronary sinus.Nasopharyngic temperature was kept at 32℃～34℃.Operation was performed on the slowly and emptily beating heart Results:Pump stopped immidiately while operation finished.Only a few patient needed low dose of dopamine to support circulation.The incidence of low cardiac output syndrome was 1 0%(2/194).No episode of air embolism was seen.The rate of hemoglobinuria, which was in positive relation to the time of CPB,was 3 8%.There was 5 operative death with a mortalily of 2 5% Conclusion:Continuously warm blood perfusion on beating heart is an good myocardial protection way closing to physiologic state. Idial clinical effect can be abtained.It is suitable to almost open heart surgery

关 键 词：浅低温 心脏不停跳心内直视手术 临床报告 心肌保护 

分 类 号：R654.2[医药卫生—外科学]