中国体外循环杂志2013，Vol.11Issue(2)：96-100,5.
开辟绿色通道救治动脉瘤患者的体外循环应对策略
Strategy of cardiopulmonary bypass for aortic aneurysm surgery in 37 cases underwent the green channel emergency operation
陈祥舟 1刘梅 1肖颖彬 1王学锋 1陈林 1李福平 1郝嘉1
作者信息
- 1. 400037重庆,第三军医大学附属新桥医院全军心血管外科研究所
- 折叠
摘要
Abstract
Objective To explore the strategy of cardiopulmonary bypass (CPB) for aortic aneurysm surgery patients underwent the green channel emergency operation and methods of the important organs protection during CPB.Methods The clinical materials and management of CPB were retrospectively analyzed for 37 cases underwent the green channel emergency operation with aortic aneurysm form Jan.2010 to Mar.2012,which included Stanford type A aortic dissection in 29 cases,ascending aorta aneurysm in 3 cases and Marfan's syndrome in 5 cases.The operation procedure included ascending aorta replacement in 9 cases combined with coronary artery bypass grafting (CABG) in 1 case,ascending aorta replacement and semi arch replacement in 3 cases,ascending aorta replacement and endovascular stent in 11 cases,Bentall procedure in 10 cases,Bentall procedure and endovascular stent in 4 cases.The perfusion methods included right femoral artery cannulation in 6 cases,right axillary artery cannulation in 22 cases,the double arterial lines (right femoral artery cannulation and right axillary artery cannulaton) with single pump head perfusion in 9 cases; and moderate hypothermia CPB in 19 cases,deep hypothermic circulation arrest (DHCA) combined with retrograde cerebral perfusion (RCP) form superior vena cava in 4 cases,DHCA combined with selective antegrade cerebral perfusion (SACP) in 14 cases.Intra-operative cell salvage (ICS) system was used in all 37 cases.Results The time of CPB,aortic cross-clamping and DHCA were 164-343 (222.1± 30.2) min,47-215 (119.7 ± 29.1) min and 3-49 (24.5 ± 11.3) min.The ultrafiltration was used in 31 cases during or at the end of CPB and filter fluid was 250-4300 (2396.3 ± 829.1) ml,the ICS washed red blood cell was 176-1645 (647.4 ± 209.1)ml.37 cases recovered consciousness after operation in 8-76 (32.7 ± 14.3) h.4 cases died postoperatively including 3 cases of multiple organs failure and 1 case of heart arrest,while others recovered well with no neurological and perfusion correlated complication.Conclusion According to the segment of aortic aneurysm and the different methods of surgical operations,the suitable method for correct cannulation and CPB are the base of successful operation.Strengthening the management of CPB and protection of important organs are the keys of decreasing the postoperative complications.关键词
绿色通道/动脉瘤/体外循环/脏器保护Key words
Green channel/ Aortic aneurysm/ Cardiopulmonary bypass/ Organ protection分类
医药卫生引用本文复制引用
陈祥舟,刘梅,肖颖彬,王学锋,陈林,李福平,郝嘉..开辟绿色通道救治动脉瘤患者的体外循环应对策略[J].中国体外循环杂志,2013,11(2):96-100,5.
