浅低温短暂停循环全弓置换手术的体外循环管理

Management of cardiopulmonary bypass for total arch replacement in mild hy⁃pothermia with transient circulatory arrest

目的探讨在浅低温短暂停循环下行全主动脉弓置换术的体外循环管理的可行性与安全性。方法本组患者均为A型主动脉夹层确诊患者,共35例,男31例,女4例;年龄(43.7±5.7)岁,体重(73.2±14.7)kg,在浅低温短暂停循环下行全主动脉弓置换术,记录围术期各种参数。结果全组患者均在浅低温短暂停循环下完成手术,术中体外循环时间189(168,205)min,主动脉阻断时间118(101,134)min,下半身停循环时间37(19,62)min,术后呼吸机辅助时间37(19,62)h,ICU停留时间58(38,80)h;围术期死亡率8.6%。结论应用浅低温短暂停循环行全主动脉弓置换术安全、可行。

Objective To evaluate the feasibility and safety of cardiopulmonary bypass(CPB)management for total aortic arch surgery in mild hypothermia with transient circulatory arrest.Methods A total of 35 patients diagnosed as Stanford A type aortic dissection(31 males and 4 females)with average age of 43.7±5.7 years and average weight of 73.2±14.7 kg were enrolled in the study,of whom underwent total aortic arch surgery in mild hypothermia with transient circulatory arrest.Perioperative characteristics were recorded.Results All patients underwent surgical treatment during mild hypothermia with transient circulatory arrest.The aver⁃age time of CPB was 189(168,205)min,the average time of aortic cross clamp was 118(101,134)min,the average time of lower-body circulation arrest was 37(19,62)min,the average time of ventilation was 37(19,62)h,and the length of ICU stay was 58(38,80)h.The perioperative motality was 8.6%.Conclusion Management of CPB for total aortic arch surgery in mild hypothermia with transient circulatory arrest is safe and feasible.