右锁骨下动脉插管体外循环技术在主动脉弓部手术中的临床应用

Clinical application of right subclavian arterial cannulation and seleted cerebral perfusion in aorta arch surgery

目的 总结右锁骨下动脉插管体外循环技术在主动脉弓部手术中的临床应用价值。方法 在深低温 ,停循环时应用右锁骨下动脉插管的选择性脑灌注技术 ,手术治疗 2 0例累及主动脉弓的心血管疾病病人。结果 所有患者均于术后 4-6h清醒 ,无死亡及脑部并发症 ,平均体外循环时间 ( 10 3 .2 6± 3 2 .8)min ,脑部低流量平均时间( 2 6.0 6± 19.18)min。结论 以右锁骨下动脉插管建立体外循环行选择性脑灌注 ,可安全地延长停循环时限及有效防止脑部并发症。

Objective To summarize the experience of the applicability of right subclavian arterial cannulation cardiovascular surgery .Methods 20 patients with cardiovascular desases underwent aortic arch surgery during deep hypothemic circulatory. arrest,and selected cerebral perfusion using right subclavian.arterial cannulation technique.Results All patients recovered from anesthesia between 4 to 6 hours after operation .There were no death and no cerebral morbidity.Mean extracorporeal circulation time was(103.26±32.8)min,The time of circulatory arrest and selected cerebral perfusion was(26.06±19.18)min.Conclusions Right subclavian artery cannulation with hypothermic circulatory arrest and antegrade selective cerebral perfusion increased ease of surgical performance and prolonged safe time limit of circulatory arrest and helps reduce cerebral morbidity.