不阻断升主动脉冠状动脉搭桥术的体外循环

Coronary Bypass under PCB without Blocking Ascending Aorta

目的 :探讨不阻断升主动脉、不灌注停跳液 ,冠状动脉搭桥手术 (CABG)的体外循环 (CPB)方法。方法 :对我院 2 3例不阻断升主动脉冠状动脉搭桥手术的临床资料及体外循环情况 (人工心肺机类型、预充液组成、CPB操作步骤、CPB时间及心肌保护等 )做一回顾性总结。结果 :CPB时间 5 0～ 1 80min(平均 85min)。转流中不阻断升主动脉、不灌注停跳液、在低温心室颤动下行心室部位的血管桥吻合 ,并结合多头灌注管的桥灌注的方法较好地保护了心肌。结论 :CPB方法采用不阻断升主动脉 ,不灌注停跳液 ,低温 ,室颤 ,结合多头灌注管的桥灌注的CABG手术可减少心肌缺血再灌注损伤现象。

Objective:To discuss a method on CABG under CPB without blocking ascending aorta and perfusion of cardiaplegia.Methods:23 cases of CABG were retrospectively studied with this method.The CPB time were 50～180 mins.The blood vessel anatomosis were performed when ventricle fibrillation under low temperature combined with bridge perfusion.Results:This method could protect myocardium well.Conclusion:The method to perform CABG under CPB without blocking ascending aorta and perfusion of cardiaplegia combined with bridge perfusion could reduce the myocardium injury caused by re-perfusion.