胸腔镜心脏手术的体外循环管理研究

发布时间：2018-10-29 14:07

【摘要】：目的总结胸腔镜心脏手术体外循环的管理,并对不同的体外循环建立策略进行分析。方法回顾性分析2010年1月至2015年8月在该院行胸腔镜体外循环心脏手术患者43例(2例中转)围术期资料,包括基本资料、手术相关资料、术后相关资料等。结果共计实施胸腔镜体外循环心脏手术患者43例,2例中转(均为前外侧切口的病例,1例因升主动脉壁薄,出血难以控制;1例为上腔型房间隔缺损修补后肺出血,重新阻断后加宽上腔静脉),全组患者无死亡病例。颈静脉/股静脉置管组整体手术病例和单纯房间隔缺损病例的主动脉阻断时间明显短于股静脉双极管组(P0.05),在转流时间、总手术时间等方面差异无统计学意义(P0.05)。结论建立稳妥、可靠的周围体外循环,强化术中体外循环的管理,对于减少主动脉阻断、体外循环转流和手术时间,降低甚至预防各种相关潜在风险和并发症的发生具有重要的临床意义。
[Abstract]:Objective to summarize the management of cardiopulmonary bypass (CPB) in thoracoscopic heart surgery and analyze the strategies of establishing CPB. Methods from January 2010 to August 2015, the perioperative data of 43 patients undergoing thoracoscopic cardiopulmonary bypass (thoracoscopic cardiopulmonary bypass) were analyzed retrospectively, including basic data, operative data and postoperative data. Results A total of 43 patients underwent thoracoscopic cardiopulmonary bypass (thoracoscopic cardiopulmonary bypass), 2 cases were converted (all cases were from anterolateral incision), one case was difficult to control because of thin ascending aorta wall. One case was pulmonary hemorrhage after repair of superior lumen atrial septal defect, then widened the superior vena cava after reocclusion. There were no death cases in all patients. The aortic occlusion time in the jugular / femoral vein catheterization group and the simple atrial septal defect group was significantly shorter than that in the femoral vein bipolar tube group (P0.05). There was no significant difference in total operative time (P0.05). Conclusion to establish a reliable and reliable peripheral cardiopulmonary bypass, strengthen the management of intraoperative cardiopulmonary bypass, can reduce aortic occlusion, CPB and operation time. It is of great clinical significance to reduce or even prevent the occurrence of various related potential risks and complications.
【作者单位】：陆军军医大学大坪医院野战外科研究所心血管外科;
【分类号】：R654.2

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