大血管手术体外循环配合的体会(附137例)

The Experience of Extracorporeal Circulation for Operation on Great Artery

目的总结大血管手术的体外循环配合的体会。方法大血管手术137例,升主动脉瘤62例,采用浅一中度低温体外循环,主动脉或股动脉插管,使用高钾氧合血停搏液。胸主动脉瘤,腹主动脉瘤,主动脉缩窄,胸腹主动脉瘤共69例,采用左心转流或股动一静脉转流。主动脉弓中断2例采用深低温停循环。其余病例采用体外循环辅助。其中1例胸降主动脉瘤和2例升主动脉瘤累及弓部行深低温停循环+选择性脑灌注。结果125例病人痊愈出院,12例病人因各种原因死亡。结论针对大血管手术的方式选择体外循环方法,以减少病人的并发症,提高手术的成功率。

OBJECTIVE To summarize the experience of extracorporeal circulation for operation on great artery. METHODS Ascending aneurysm 62 cases, with cannulalion on aortic or femoral artery, and high-dose potassium oxygenated blood cardioplegia, 69 cases of descending aneurysm, abdominal aneurysm, aortic coarctation and thoracic-abdominal aneurysm, with left-heart circulation or femoral arterial and venous cannulation, 2 cases of interruption of aortic arch with deep hypothermic circulatory arrest, other cases with the assistance of extracorporeal circulation, Among the cases, 3 cases were given deep hypothermic circulatory arrest and selective cerebral perfusion. RESULTS 125 cases were cured, 12 cases died of different causes. CONCLUSION In order to decrease the complications and ensure successful operation, extracorporeal circulation must be given according to the method of operation on great artery.