15例法乐四联症手术的体外循环管理

Management of cardiopulmonary bypass in tetralogy of fallot operations;Areport of 15 cases

目的对15例法乐氏四联症(TOF)根治术患者的体外循环(CPB)术中管理进行回顾性总结。方法15例中男10例,女5例,年龄5～28岁,体重16～57kg,11例采用中低温中高流量,4例采用深低温低流量,10例用冷晶体停跳液灌注,5例用4∶1冷氧合血停跳液灌注。转流前静脉放血4例,转流中超滤4例。结果除1例因术后重度低心排综合征加上肺部感染死亡外,其余患者均治愈出院。结论针对TOF的特点,选用合适的体外循环方法,对手术成功具有重要作用。

Objective 15 tetralogy of Fallot cases cardiopulmonary bypass peri -operative management were reviewed retros pectively. Methods Among 15 cases, 10 patients were male and the other 5 female. Age from 5 to 28 y. o. weight 16 -57 kg. 11 cases adopted mild hypothermia with mild and high flow. 4 cases adopted deep hypothermia and low flow. 10 cases adopted cold crystalloid cardioplegia perfused and 5 cases perfused with 4 ： 1 cold oxygen - containing blood cardioplegia. Some blood was bleeding through the vein draining tube before bypass in g cases and ultrafiltration used during bypass in 4 cases. They achieved fairly good. Results One patient died of post - operative severe low cardiac output and respiratory infection. All other patients were successfully treated and discharged. Conclusions Suitable selection of the method of cardiopulmonary bypass determines the outcome and prognosis after surgery.