泵控脑灌注在主动脉弓置换手术中的应用

The application of cerebral perfusion controlled by individual pump in aortic arch replacement

目的探讨泵控脑灌注技术在主动脉弓置换手术中应用的可行性与安全性。方法回顾性分析北部战区总医院2021年7月至2022年1月46例行主动脉全弓置换术患者的临床资料,所有患者均在浅低温停循环下行主动脉弓置换手术并应用泵控脑灌注技术实施选择性脑灌注,记录患者围术期临床资料。结果全组患者围术期死亡4例(8.7%),体外循环时间(182.3±27.1)min,主动脉阻断时间(112.1±25.6)min,停循环时间(8.2±1.9)min,脑灌注时间(56.7±9.3)min,术后短暂神经系统并发症发病率8.7%。结论泵控选择性脑灌注技术安全、可行,可能对防止术中“奢灌”的发生有益,但仍需进一步研究验证。

Objective To evaluate the safety and feasibility of cerebral perfusion controlled by individual pump in aortic arch replacement.Methods The clinical data of 46 patients undergoing total aortic arch replacement from July 2021 to January 2022 in our department were retrospectively analyzed.All patients underwent aortic arch replacement with mild hypothermic circulatory arrest and selective cerebral perfusion with pump-controlled cerebral perfusion technology,and their perioperative clinical data were recorded.Results The perioperative mortality was 8.7%.The time of cardiopulmonary bypass,aortic crossclamp,circulatory arrest and cerebral perfusion was 182.3±27.1 min,112.1±25.6 min,8.2±1.9min and 56.7±9.3min,respectively.And the morbidity of transient neurological dysfunction was 8.7%.Conclusion The pump-controlled selective cerebral perfusion technology is safe and feasible in total arch replacement,which might be benefit for preventing"luxury perfusion",however,it still needs further research and verification.