瓣膜病合并肝功能不全患者的体外循环管理  

Management of Cardiopulmonary Bypass in Heart Valve Replacement of Patients with Liver Dysfunction

作　　者：张风英[1] 高扬[2] 王利[2] 王建清[2] 贺文芳[2] 

机构地区：[1]北京市垂杨柳医院心脏外科,北京100022 [2]大同市第五人民医院心胸外科,山西大同037006

出　　处：《中国体外循环杂志》2004年第1期44-45,共2页Chinese Journal of Extracorporeal Circulation

摘　　要：目的　回顾 5 2例瓣膜病变合并肝功能不全的行瓣膜置换术的患者 ,总结体外循环 (CPB)经验。方法　CPB采取中度低温 ,保持较高的灌注压力。预充液加入白蛋白。心肌保护用高钾含血停搏液灌注。结果　结果CPB时间 5 0～ 135min ,主动脉阻断 2 3～ 98min ,心脏自动复跳率 94 % ,无全心辅助和左心辅助 ,围术期死亡 6人。结论　术中加强心肌保护的同时重视肝保护 ,可减轻术后心功能衰竭和肝功能衰竭 ,降低并发症和死亡率。OBJECTIVE To review the experience of 52 patients with heart valve diseases assciated with liver dysfunction undergoing cardiopulmonary dypass(CPB).METHODS Moderate hypothermia and maintaining higher infusion pressure were used during CPB. Albumin was added into the prime before CPB,blood cardioplegia was used for myocardial protection in all patients. RESULTS CPB time rangde from 50 to 135 min, the aortic clamped time rangde from 23 to 98 min. Resustitation of heart was 94%. 6 patients died in perioperation.CONCLUSION Strengthening myocardias protection and liver protection can reduce postoperative heart failure and liver failure, mortality and morbidity.

关 键 词：瓣膜病 合并症 肝功能不全 体外循环 管理 瓣膜置换术 

分 类 号：R654.2[医药卫生—外科学] R654.1[医药卫生—临床医学]