上腔静脉逆行灌注救治体外循环期间动脉大量气栓  

Retrograde Perfusion Through Superior Vena Cava in the Management of Massive Arterial Air Embolism During Cardiopulmonary Bypass

作　　者：易定武[1] 吴曼蓉[1] 赵平[1] 刘少琼[1] 彭敏辉[1] 高绍英[1] 

机构地区：[1]中南大学附属湘雅二医院心胸外科体外循环组,湖南长沙410011

出　　处：《中国体外循环杂志》2003年第4期239-240,共2页Chinese Journal of Extracorporeal Circulation

摘　　要：目的介绍3例上腔静脉逆行灌注治疗体外循环(CPB)期间动脉大量气栓的体会。方法发生气栓时立即停止心肺转流,以小于25mmHg的压力行上腔静脉逆行灌注,排尽气体。再恢复正常的心肺转流。术后辅以镇静、脱水、大剂量皮质激素及人工冬眠等治疗。结果3例患者均痊愈出院,分别随访1个月～7年,均未遗留神经系统后遗症。结论上腔静脉逆行灌注救治CPB期间动脉大量气栓确实有效,应在气栓发生后立刻施行,必要时还可辅以人工冬眠疗法。OBJECTIVE This article reviewed the management of 3 cases of massive arterial air embolism during car-diopulmonary bypass (CPB). METHODS The antegrade perfusion was stopped as soon as the massive arterial air embolism occured and retrograde perfusion through superior vena cava(RPSVC) was performed immediately for 10 ~ 14min. The restrograde perfusion pressure was less than 3. 33 kpa . Normal CPB were performed afterward to assist circulation. Sedative , dehydration , large dosage corticoid therapy and artificial hibernation were used postoperatively . RESULTS Three patients survived and were followed up for 1 month to 7 years without any neurological sequelae. CONCLUSION Retrograde perfusion through superior vena cave is a remedy for the massive arterial air embolism which may occur during CPB . It should be used as soon as massive arterial air embolism occurs. Artificial hibernation may be useful when necessarily.

关 键 词：体外循环 动脉气栓 上腔静脉逆行灌注 心肺转流 

分 类 号：R654.1[医药卫生—外科学]