主动脉弓手术中脑损伤与脑保护研究进展

Research progress in brain injury and brain protection during aortic arch surgery

尽管心脏手术和麻醉技术取得了巨大进步,但在需要停循环的主动脉弓手术中,脑损伤的发生率仍然很高,严重影响患者的预后。通过综述目前主动脉弓手术体外循环期间参与脑损害的各种因素和可能的发病机制,包括脑栓塞、脑血流量不足、炎症反应,以及现在主流的脑保护方法和药物,如低温停循环、脑灌注、抗炎药物和血气管理在内的多种脑保护技术。为心脏外科医生提供更高质量的术后脑部策略或意见,提高心脏手术患者的预后和生活质量。

Although great progress has been made in cardiac surgery and anesthesia techniques,the incidence of brain injury in aortic arch surgery requiring circulatory arrest is still very high,which seriously affects the prognosis of patients.This article reviews the various factors and possible pathogenesis of brain damage during cardiopulmonary bypass in aortic arch surgery,including cerebral embolism,insufficient cerebral blood flow,inflammatory reaction,and the current mainstream brain protection methods and drugs such as hypothermic circulatory arrest,cerebral perfusion,anti-inflammatory drugs and blood gas management.This provides higher quality postoperative brain strategies or opinions for cardiac surgeons,and improves the prognosis and quality of life of patients undergoing cardiac surgery.