摘要
目的 :评价体外循环下不阻断升主动脉行心内直视术对心肌的保护作用。方法 :对 1995年 9月至 2 0 0 0年 5月在心内直视术中应用此法的 6 5 5例病人进行回顾。全组男 334例 ,女 32 1例。年龄 4个月～ 6 3岁 (平均 16 0 6± 13 16岁 )。体重 5～ 92kg(平均 2 8 5 6± 17 84kg)。病种包括先心、风心和心脏肿瘤 ,其中婴幼儿 87例。 5 13例于浅低温 (鼻温 34～ 32℃ )体外循环不阻断升主动脉心脏跳动下手术 ,142例于中低温 (鼻温 30～ 2 8℃ )心脏停跳下手术。结果 :术后并发症 :低心排11例 ,支气管痉挛 3例 ,二次进胸止血 2例 ,肺膨胀不全 2例 ,脑气栓 1例。住院死亡率 0 91% (6 / 6 5 5 ) ,分别死于低心排3例 ,呼吸衰竭 2例 ,肾衰 1例。结论 :体外循环下不阻断升主动脉心内直视术是临床效果满意 ,安全有效的心肌保护方法 。
Objective:To evaluate the effect of no aorta--clamping on myocardial protection under cardiopulmonary bypass(CPB) during open heart surgery.Methods:Between Sep.1995 and May,2000,655 patients(male 334 and female 321,aged from 4 months to 63 years) (mean 16.07±13,16 years,weighing from 5 to 92kg(mean 28.56±17.84kg),underwent open heart surgery using the technique of no aorta-clampingunder CPB.The heart diseases included congenital disorders,rheumatic valve and tumors.Among them 87 were infants.Five hundred thirteen patients were operated with heart jumping under mild hypothermia (nasopharyngeal temperature 34～32℃),and 142 patients operated without jumping under moderate hypothermia(30～28℃).Results:Postopreative complications were orderly:low output syndrome in 11 cases,bronchial spasm in 3 cases,secondary thoracotomy for hemostasis in 2 cases,pulmonary atelectasis in 2 cases,air embolism in 1 case.The hospital mortality was 0.91%(6/654).The causes of death were low output syndrome in 3 cases,respiratory failure in 2 cases,and renal failure in 1 case.Conclusion:No aorta-clamping is a feasible,effective and safe technique for myocardial protection during CPB.The technical skill of preventing air embolism should be emphasized.
出处
《宁夏医学院学报》
2000年第6期399-401,共3页
Journal of Ningxia Medical College
关键词
体外循环
心内直视术
不阻断升主动脉
heart disease
cardiopulmonary bypass
open heart surgery
aorta-clamping
hypothert
