深低温停循环在腔静脉内瘤栓清除术中的应用

Deep Hypothermic Circulatory Arrest for Removal of Vena Cava Tumor Thrombus

目的:总结深低温停循环应用在腔静脉内瘤栓清除术中的技术特点。方法:回顾性分析1999-12至2007-06应用深低温停循环技术清除上下腔静脉、右心房内瘤栓21例。结果:手术过程顺利。体外循环转流86～118min,平均(102.33±16.52)min,停循环36～64min,平均(47.12±10.86)min。术后全部患者清醒,术后清醒时间6～72h,平均(14.32±6.98)h,术后呼吸机辅助时间18～120h,平均(20.54±10.72)h。1例术后6天死于心力衰竭、1例术后19天死于肾功能衰竭;其余均康复出院,随访6～64个月无远期并发症。结论:体外循环及深低温停循环对上、下腔静脉及右心房内的瘤栓清除是安全有效的手术保障。

Objective： To summarize the technical characteristics of deep hypothermic circulatory arrest for removal of vena cava tumor thrombus during the open chest cardiac surgery. Methods： A total of 21 patients who underwent vena cava and right atrium tumor thrombus removal with deep hypothermic circulatory arrest from December 1999 to June 2007 in our hospital were retrospectively studied. There were 13 male and 8 female patients with the mean age of （46. 4 ± 15.7） years. General anesthesia with intubation was performed to establish the on-pump condition. Results： The mean on-pump bypass time was（102. 33 ± 16. 52） min,the mean circulatory arrest time was（47.12 ± 10. 86） min,and the average mechanical ventilation time was （20. 54 ± 10. 72） hours. There were 19 patients recovered and discharged after the surgery, 1 patient died of heart failure 6 days after the surgery, and another died of kidney failure 19 days after the surgery. The patients were followed up from 6 to 64 months, no long-term complications were observed. Conclusion： Deep hypothermic circulatory arrest was feasible and safe for vena cava and right atrium tumor thrombus removal.