瓣膜置换术中心脏停跳和不停跳体外循环比较

Comparison of the management of cardiopulmonary bypass with beating or arresting heart in valve replacement surgery

目的比较心脏停跳 (AH)和不停跳 (BH)瓣膜置换术 (VR)体外循环 (CPB)管理及效果的异同。方法观察201例VR患者 ,其中AH90例 ,BH111例。比较两组在CPB期间及术后相关指标的改变。结果两组相比 ,BH组转流时间和阻断时间较短、使用库血例数和库血用量、钾和碳酸氢钠用量、术中失血量等均较少(P<0.05)。结论心脏不停跳瓣膜置换手术在CPB管理方面优于心脏停跳瓣膜置换手术。

Objective To study the difference in the management of cardiopulmonary bypass (CPB) with a beating heart (BH) or an arresting one (AH) in valve replacement operation (VR). Methods 201 cases of VR were divided into group BH (n=111) and group AH (n=90). The pre-and postoperative course of all the cases were compared. Blood gas, serum electrolytes, urine output and the amount of the drugs administered were recorded and analyzed statistically. Results The operative mortality was 1.8% in group BH and 4.2% in group AH. No bypass-related death was found in both the groups. The amount of KHCO3 and NaHCO3 administered and blood transfused was much less in group BH than in group AH but that of vasorelaxant used was larger in the former than in the latter. Conclusion CPB with a BH for VR is safer and easier to manage.