经腋动脉右锁骨下动脉插管和选择性脑灌注技术的应用

Technique of Right Subclavian Arterial Cannulation and Selected Cerebral Perfusion in the Surgery of Cardiovascular Diseases Involving Aortic Arch

目的 介绍经腋动脉右锁骨下动脉插管技术及其体外循环要点。 方法 经腋动脉右锁骨下动脉插管和在深低温停循环下行持续选择性脑灌注技术治疗累及主动脉弓的心血管疾病患者７０ 例。 结果 应用该技术手术治疗累及主动脉弓的心血管疾病７０ 例中，脑部低流量灌注时间最长达８１ 分钟，平均２８ ．０６ ±２１ ．０７ 分钟，术后患者６ 小时内全部清醒，无神经系统并发症。 结论 经腋动脉右锁骨下动脉插管在停循环期间持续选择性脑灌注方法对脑保护简便、安全、有效。

Objective To study the technique of right subclavian arterial cannulation and extracorporeal circulation. Methods To study the topographic anatomy of subclavian artery and axillary artery, to introduce the technique of right subclavian arterial cannulation, and summarize the experience of 70 patients with cardiovascular diseases underwent aortic arch surgery during deep hypothemic circulatory arrest and selected cerebral perfusion.Results The longest time of circulatory arrest and selected cerebral perfusion was 81 minutes, all of the patients was successfully treated without neurologic complication. Conclusion This technique of cerebral protection is handy, safe and effective during deep hypothemic circulatory arrest and selected cerebral perfusion.