青海高原556例体外循环转流回顾分析

ANALYSIS OF 556 CASES OF CARDIOPULMONARY BYPASS AT QINGHAI HIGH ALTITUDE

本文报告1981～1992年8月期间在海拔2260 m高原地区西宁市开展556例体外循环心内直视手术。其中414例采用中深度血液稀释,中到深度低温、高流量动脉灌注,取得了较好效果。鉴于高原地区低氧环境,应重视术前及术中心肌保护,术后加强呼吸管理。

Open-heart surgery of 556 cases under cardiopulmonary bypass (CPB) in Xining (2 260 m above sea level) between 1981 and 1992 was reported. Four types of CPB were performed in open-heart surgery. Profound hemodilution and hypothermia with high blood flow were applied by CPB in 414 cases. Hemoglobin concentrations of most patients (56%) were over 120 g/L. During CPB, hemoglobin concentration was maintained between 35～55 g/L and hematocrit 12%～22%. The results showed that there were no bypoxia and metabolic acidosis. At the end of CPB, hemoglobin was 78.8±14. 7 g/L and hematocrit 29.7±9.3%. The incidence of PDA with serious pulmonary arterial hypertension is high, therefore ,operation of PDA with profound hypothermia and low blood flow under CPB is indicated at high altitude. Owing to hypoxia in the plateau, respiratory management is very important after open-heart surgery.