摘要
目的:总结Bentall手术治疗马凡氏综合征中的体外循环(Extracorporeal circulation,ECC)实施方法的管理经验。方法:回顾2004年10月至2012年10月,共对23例马凡氏综合征患者施行了Bentall手术。术中采用中低温体外循环转流,经右腋动脉或右侧股动脉插管,右房二极管或上下腔静脉插管引流,冷血晶体(4:1)心脏停搏液灌注。结果:体外循环转流时间(164.35±43.22)min、心肌阻断时间(103.58±74.52)min;转中超滤(2800±1140)mL;使用库血量(2±1)U,回收机处理血量(1635±1020)mL,回收血量(548±224)mL;重症监护室时间12-324(63±59)h;院内死亡2例,1例因形成夹层动脉瘤在开胸过程中出现夹层破裂大出血,另1例术后出现低心排。结论:马凡氏综合征患者实施Bentall手术中,采用正确的体外循环管理方法,可以得到较为满意的治疗效果。
Objective： To summarize the managerial experience of extracorporeal circulation （ECC） for Marfan ＇ s syndrome by Bentall procedure. Method： Analysing 23 Marfan ＇ s syndrome patients underwent Bentall procedure from Oct. 2004 to Oct. 2012. We did the ECC at medium and low temperature , put the tube through the right axillary artery or femoral artery , drained through the fight atrium by bipolar tube or superior vena cava and inferior vena cava, protected the myocardium from cold-blood Crystal 14：11 cardioplegia. Result： The mean ECC time was （ 164.35±43.22 ） min, and mean aortic clamp time was （ 103.58±74.52 ） rain. The volume of ultrafiltration was （ 2800± 1140 ） mL; the amount of used blood was （ 2 ± 1 ） U ; the recycling machine dealed with blood 11635~1020） mL ;recycled blood （548~224） mL. Mean ICU stay time was 12-324{63＋59）hours. 2 patients died in the hospital,1 patient died from the rupture of aortic dis- section during the procedure to open the chest, 1 patient appeared low cardiac output syndrome after the operation. Conclusion. During the procedure of Bentall for Marfan＇ s syndrome patients , using suitable management of ECC could obtain satisfactory clinical effects.
出处
《河北医学》
CAS
2013年第11期1613-1616,共4页
Hebei Medicine
