深低温停循环手术中肺部温度变化初步观察

Primary Investigation of Pulmonary Temperature Changes in Patients Undergoing Deep Hypothermic Circulatory Arrest

目的观察深低温停循环过程中肺部温度的变化规律,为深低温停循环过程中肺保护提供参考。方法4例在深低温停循环下行主动脉弓部手术的患者纳入本研究,全麻完成后,经右侧颈外静脉穿刺置入Swan-Ganz导管,导管气囊漂入肺动脉,测试可以测定肺毛细血管嵌压后,气囊充气,远端温度探头可以测定手术过程中肺深部温度,同时监测鼻咽温度和直肠温度。结果4例深低温停循环手术患者的肺部温度可降低到16.6℃,接近鼻咽温度16.4℃,在降温过程中比鼻咽温略低,在复温过程中比鼻咽温略高。结论深低温停循环过程中,肺部温度可达到深低温要求。

OBJECTIVE To observe pulmonary temperature change in patients Undergoing aortic arch surgery with cardiopulmonary bypass（CPB） and deep hypothermic circulatory arrest（DHCA）.METHODS Four patients with type Ⅰ acute aortic dissection who underwent aortic arch surgery with cardiopulmonary bypass（CPB） and deep hypothermic circulatory arrest（DHCA） were enrolled in this study.Swan-Ganz catheter was advanced into pulmonary artery before operation.When catheter balloon was inflated,the thermo sensor in the tip of the catheter could be used to record pulmonary temperature,anal and nasopharyngeal temperatures were also recorded during CPB and DHCA.RESULTS The pulmonary temperatures of the 4 patients were cooled down to 16.6℃,which were almost equal to their nasopharyngeal temperatures of 16.4℃.Generally,pulmonary temperature changed parallel with nasopharyngeal temperature,and it was a little lower than nasopharyngeal temperature during cooling down period and a little higher than nasopharyngeal temperature during warming up period.CONCLUSION Pulmonary temperature can be cooled down to deep hypothermia during aortic arch surgery with CPB and DHCA.