体外循环心内直视手术42例体会

Open heart surgery under hypothermic anaesthesia with extracorporeal circulation(42 cases reported)

目的 总结 42例体外循环心脏直视手术的经验。方法 全组 42例 ,男性 2 4例 ,女性 18例 ;年龄 1～ 61岁 ,体重 9.5～ 84kg。均在低温体外循环下进行手术 ,房缺修补 9例 ,室缺修补 2 1例 ,法乐四联症 1例 ,瓣膜替换11例。 3例合并其他畸形 ,予以同期矫治。结果 体外循环时间在 43～ 15 0min ,主动脉阻断时间 14～ 97min ;术后 3 0日内死亡 3例 (7.1% ) ,并发症发生率 11.9%。 3 9例随访 1月～ 6年均恢复较好。结论 开展心脏直视手术 ,起初选择病例应本着安全第一的原则 ;加强体外循环管理 ,重视心肌保护 ,正确矫正心脏畸形 ,强调术后处理 。

Objective\ To summarize the experience of open heart surgery with extracorporeal circulation on 42 patients. Methods\ 42 operations for the heart disease were performed during May 1996 and April 2002. There were 24 males and 18 females,ranging from 1 to 61 in age (mean 26.7 ),9.5 to 84kg in body weight .Open heart surgeries under hypothermic anaesthesia with extracorporal circulation were performed on all the patients among whom 9 underwent ASD repair,21 VSD repair,1 corrective surgery of TOF and 11 valve replacement.Cardiac malformations were corrected in another 3 cases. Results\ Extracorporeal circulation took 43 to 150 min. The total time of aortic cross clamping was 14 to 97 min. The operative mortality was 7.1% and the morbidity rate 11.9%. 39 patients recovered well postoperatively in one month to six years . Conclusion\ Accurate extracorporal circulation management,the proper myocardial protection,correct postoperative management and prevention of complication are all crucial to the success of the surgery.