肺动脉血栓内膜剥脱术的80例体外循环经验回顾

Single-center experience in extracorporeal circulation in 80 cases of pulmonary thromboendarterectomy

目的回顾性分析北京朝阳医院80例体外循环下肺动脉血栓内膜剥脱术(PTE)临床结果,总结围体外循环期的管理经验。方法收集北京朝阳医院2002年4月至2015年12月期间体外循环下PTE的相关临床与术后的随访资料。结果共完成PTE 80例,其中男性62例,女性18例,平均年龄(45±12)岁。其中67例PTE术中采用深低温停循环方式,13例PTE术中采用深低温低流量方式。体外循环时间(278.0±72.7)min,阻断时间(123.1±31.1)min,辅助时间(94.9±41.4)min,停循环总时间为(38.3±14.5)min。术后气管插管时间(97.2±70.5)h,术后ICU停留时间(9.5±6.0)d。结论 PTE是治疗肺动脉栓塞的有效治疗方法,围体外循环期管理水平的提高和整体手术团队通力协作有助于改善减少术后并发症的发生。

Objective To retrospectively analyze the clinical results of 80 cases of pulmonary artery thrombosis（thromboen-darterectomy pulmonary, PTE） in Beijing Chaoyang Hospital, and summarize the management experience of perioperative managementof cardiopulmonary bypass.Methods The clinical data and postoperative follow-up data of PTE were collected from April 2002 to De-cember 2015 in Beijing Chaoyang Hospital.Results 80 PTE cases were completed, including 62 males and 18 females, with an aver-age age of（45±12） years. Deep hypothermia circulatory arrest was used in 67 cases of PTE, deep hypothermia low-flow perfusionwere 13 cases of PTE.Cardiopulmonary bypass time（278±72.7） min, cross-clamp time（123.1±31.1） min, auxiliary time（94.9±41.4） min, total time of circulatory arrest was（38.3±14.5） min. Postoperative mechanical ventilation time（97.2±70.5） hours, the post-operativetime stay in ICU was（9.5±6） days.Conclusion PTE is effective method for the treatment of pulmonary embolism, and im-proved extracorporeal circulation management level alongside the overall surgical team collaboration will helps reducing the incidence ofpostoperative complications.