体外循环心脏手术复苏困难的原因分析及处理

Causes Analysis and Treatment of Cardiac Resuscitation Difficulty in Cardiac Surgery with Extracorporeal Circulation

目的总结体外循环(extracorporeal circulation,ECC)心内直视手术中心脏复苏困难的原因及处理方法。方法对本院2003年1月至2005年6月行ECC心内直视手术的15例心脏复苏困难患者情况进行回顾分析。结果处理方法包括再次阻断升主动脉、温血灌注;冠状静脉窦逆灌;纠正酸碱电解质失衡等方法等。15例患者均顺利脱离ECC。结论ECC心内直视手术中心脏复苏困难的原因与心脏本身病变、气栓、酸碱电解质失衡等因素有关。

OBJECTIVE To summarize the causes and treatments methods of 15 cases with difficulty of cardiac resuscitation（CR） in open heart surgery with extracorporeal circulation（ECC）.METHODS The clinical materials of cases with difficulty of CR during open heart surgery with ECC in my hospital from 2003（1） to 2005（6） were analyzed retrospectively.RESULTS The treatments included re-blocking the aorta,warm blood perfusion,retrograde perfusion through vena coronaria sinus and correction of electrolyte and acid-base balance disturbance.All cases departed with ECC smoothly.CONCLUSION The causes of the difficulty of CR during open heart surgery with ECC are concerned with the cardiac diseases and other causes,including gas embolism,electrolyte disturbance and acid-base balance disturbance.