重症心脏瓣膜替换术的体外循环管理-东南大学学报医学版

重症心脏瓣膜替换术的体外循环管理

单位：1.东南大学附属中大医院,胸心外科,江苏,南京,210009； 2.南通瑞慈医院,麻醉科,江苏,南通,226300

分类号：R654.1

出版年·卷·期（页码）：2005·24·第五期（337-339）

摘要：

目的:总结体外循环(CPB)管理的方法.方法:回顾分析82例重症心脏瓣膜病行瓣膜替换术患者资料,CPB采取中度低温,中度血液稀释,保持较高的灌注压力;4:1氧合血停搏液灌注心肌保护.结果:CPB时间85～235 min,主动脉阻断62～198 min,心脏自动复跳率85%,无全心辅助和左心辅助,围术期死亡1例.结论:术中有效的心肌保护、提高胶体渗透压以及重视其它脏器的保护,可减轻术后心功能衰竭及其它重要脏器功能衰竭,降低并发症和死亡率.

Objective To retrospectively analyze the clinical data of 82 serious cardiac patients with heart valve diseases undergoing cardiopulmonary bypass.Methods Mild hypothermic and hemodilution and high infusion pressure were kept in all patients during CPB.Myocardial protection during ischemia was obtained by 4∶1 blood cardioplegia solution.Result The periods of CPB lasted from 85 to 235 min.The aortic clamped time ranged from 62 to 198 min.The recovering subsultus ratio of the hearts is 85%.Resustitated 1 patients died in perioperation.Conclusion Effective myocardiac protection and rasie of blood crystalloid pressure,strengthening the other organs protection can reduce postoperative heart and other organ failure,mortality and morbidity.

参考文献：

[1] 龙村. 体外循环学, 2004
[2] 龙村, 岳红文. 晶体停搏液和氧合血停搏液的临床应用研究. 中国体外循环杂志1996
[3] 龙村. 体外循环手册, 1997
[4] 王质刚. 血液净化技术的进展, 1999(3)
[5] FANG W C, HELM R E, KRIEGER K H. The impact of low hematocrit during cardiopulmonary bypass on outcome in patients undergoing coronary artery, 1996(z1)

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