胸腔镜心脏手术微创体外循环的建立方法

The method of setting up micro-invasive cardiopulmonary bypass for thoracoscopy cardiac surgery

目的 :介绍电视胸腔镜实施心脏手术时微创体外循环的建立方法。方法 :3例先天性心脏病房间隔缺损患者采用股动脉、股静脉插管和经第四肋间插入上腔静脉插管建立的微创体外循环 ,借助电视胸腔镜修补房间隔缺损。结果 :3例患者体外循环转流时间分别为 72min、74min、83min ,主动脉阻断时间为 34min、32min、35min ,平均灌注压 (桡动脉压 )维持在 6 8～ 80mgHg ,动脉线压力 180～ 2 18mmHg ,转流中尿量为 75 0ml、15 0 0ml、85 0ml;灌注流量在 2 0～ 2 3L·m-2 ·min-1。 3例患者体外循环过程平稳均顺利停机。结论 :经股动脉、股静脉和上腔静脉插管建立微创体外循环可以满足电视胸腔镜心脏手术操作过程中的灌注要求 ,其方法安全可行。

Objective:This study is to introduce a method to set up micro\|invasive cardiopulmonary bypass for open heart surgery with thoracoscopy.Method:Three patients diagnosed atrial septal defect were set up micro\|invasive cardiopulmonary bypass by right femoral vein,femoral artery and superior vena cava with thoracoscopy for closing the atrial septal defect.Result:For three patients the cardiopulmonary bypass time were 78 min,72 min,83 min,the aortic cross clamping time were 34 min,32 min,35 min.The mean perfusion pressure was 68～80 mmHg.The process of cardiopulmonary bypass went on smoothly.Conclusion:Setting up micro\|invasive cardiopulmonary bypass by femoral vein,femoral artery and superior vena cava was feasibility and safety for thoracoscopy used in closing the atrial septal defect. [