胸主动脉瘤术中预防脑损伤的研究  

Study of preventing cerebral injury in the procedures of thoracic aneurgsms

作　　者：徐银祥 徐平[2] 

机构地区：[1]东营市人民医院,山东东营257091 [2]青岛大学医学院附属医院

出　　处：《山东医药》2004年第9期9-10,共2页Shandong Medical Journal

摘　　要：目的　对胸主动脉瘤术中脑损伤的预防进行临床研究。方法　对 72例主动脉弓部和近弓部主动脉瘤患者采取选择性锁骨下动脉脑灌注、深低温停循环 (DHCA)、DHCA+上腔静脉逆行灌注等方法实施脑保护。结果　术后 7例出现暂时性脑功能障碍 ,神志分别于术后 4～ 7天恢复。 3例并发脑损伤死亡。随访 3个月至 11年 ,术后短暂性脑功能障碍患者神经功能正常。结论　 1选择性锁骨下动脉脑灌注符合解剖、生理 ,手术野清晰 ,可有效实施脑保护 ,避免脑损伤 ,是主动脉弓部和近弓部主动脉瘤手术首选脑保护措施。2提高手术技术 ,缩短手术时间 。Objective To summarize the surgical experience about how to prevent cerebral injury due to the procedures of thoracic aneurysms Methods The procedures of all the aortic arch and some ascending aortic aneurysms were finished under selective subclavicular artery perfusion in 23 cases,and another 12 cases were performed under deephy pothermic circulation arrest(DHCA) and retrograde cerebral perfusion (RCP) Results 63 patients in the group were cured 7 patients,postoperatively,suffered from transient unconsciousness,whereas they recovered soon from the fourth day to the fifteenth day after operation respectively 3 patients died from the cerebral injury postoperatively Conclusion Selective subclavicular artery perfusion is of statistical difference from the femoral artery perfusion and DHCA+RCP respectively The former will be the first choice in cerebral protection for the aortic arch aneurysms because of its reliable effect Improving the surgical technique and shrinking procedures will be the reliable measures of reducing the incidence of cerebral injury

关 键 词：胸主动脉瘤 术中 预防 脑损伤 深低温停循环 

分 类 号：R543.16[医药卫生—心血管疾病]