普胸外科中急诊体外循环的应用

Clinical application of emergency cardiopulmonary bypass in thoracic surgery

目的 评价应用急诊体外循环 (ECPB)抢救普胸外科危重病人的效果 ,探讨ECPB开展的条件、方法及临床应用指征。方法 应用ECPB抢救普胸外科危重病人 7例 ,术中紧急实施供血插管及肝素化措施 ,建立体外循环 ,抢救病人生命。结果 7例中 6例存活 (生存率 85 7% ) ,1例心肺复苏成功 ,但由于体外循环建立前缺氧时间过长 ,术后 2周死于急性肾功能衰竭。随访的 4例 1a内死于癌复发。结论 ECPB是抢救普胸外科危重病例的一种非常有效的治疗手段 ,在恶性肿瘤病人中仅在紧急情况下挽救病人生命时使用。

Objective To evaluate the effect of ECPB in thoracic surgery under emergency situation.Methods From February 1993 to February 2003,7 severe patients were performed with ECPB.Cardiopulmonary bypass was established urgently in order to save patient's life.Results 6 cases survived (the survival rate was 85.7%),1 case died of acute renal failure after 2 weeks.In one year,4 cases died of cancer recurrence.Conclusion ECPB is effective in rescuing severe patients who need urgent treatment in thoracic surgery,but ECPB is only used under emergency situation.