冠状动脉搭桥手术的体外循环方法

Cardiopulmonary bypass of coronary artery bypass grafting

目的 :总结冠状动脉搭桥手术的体外循环方法。方法 :对 1998～ 2 0 0 3年的 13 2例冠状动脉搭桥手术的体外循环情况进行总结 ,分析其临床资料、术中搭桥支数、体外循环时间、阻断时间、转流温度、停跳液使用情况、术后呼吸机时间、多巴胺支持率和IABP使用的情况。结果 :13 2例患者平均搭桥 3 .2支 ,体外循环时间 63～ 2 13min ,平均 13 2min ,升主动脉阻断时间 3 9～ 14 8min ,平均5 2min。 4 1(血晶体液 )含血停跳液温 -冷 -温方法灌注结合桥灌 ,较好地保护了心肌。应用抑肽酶和乌司他丁 ,更好地做好血液保护和心肌保护。主动脉内球囊反搏在救治低心排患者时起到重要而有效的作用。结论 :含血停跳液温 -冷 -温方法灌注结合桥灌 ,合理的体外循环方法 ,充分的血液保护对提高冠状动脉搭桥手术成功率起重要作用。

Objective To summarize the technology of cardiopulmonary bypass of coronary artery bypass grafting. Methods The data were summarized in 132 cases of coronary artery bypass grafting. From 1998 to 2003, including clinical data, the number of grafted vessels, cardiopulmonary bypass time, aortic clamping time, temperature, respirator supported time, the application of cardioplegia, IABP and dopamine. Results Of the 132 patients, average number of grafted vessels was 3.2. Cardiopulmonary bypass time 63 to 213 minutes. Aortic clamping time was 39 to 148 minutes. 4:1 blood cardioplegia by warm-cold-warm method and from vessel bridge could protect myocardium better. Ulinastatin and aprotinin were good for myocardial protection and blood protection. Intra-aortic balloon pump was important and oprative method of saving low cardiac output. Conclusion Blood cardioplegia by warm-cold-warm method and from vessel bridge, reasonable method of cardiopulmonary bypass and sufficient blood protection is very important in coronary artery bypass grafting procedures.