初期开展心脏直视手术体外循环体会

目的总结两年来开展心脏直视手术体外循环的经验体会,以提高体外循环的操作技术和管理水平。方法本组26例心脏患者,常规晶体预充排气,中浅低温高流量体外循环,心肌保护采用改良圣托马氏心脏停搏液。结果心脏自动复跳18例,自动复跳率80%。全部病人术后恢复良好,未见明显的并发症和后遗症。结论灌注师在术前做好各方面的充分准备,在术中与手术医师、麻醉师、手术护士密切配合,合适的血液稀释以及积极的心肌保护均为手术成功与否的关键所在。同时,术中加强对血气、电解质、尿量的监测和术后加强随访也相当重要。

EXPERIENCES IN EXTRACORPOREAL CIRCULATION OPEN HEART SURGERY IN EARLY STAGE

Objective To Review the two year's experiences in extracoporeal circulation of open heart surgery for improvement of the cardiopulmonary bypass (CPB) technique. Methods Jstra roller pump? bubble oxygenator and arterial line filter were used in 26 patients. Crystalloid priming solution, low-medium hypothermic and high flow CPB were adopted. Myocardial protection was performed with modified St. Thomas cardioplegia. Results 18 cases heartbeat returned automatically(80%). All cases recovered smoothly without any complications. Conclusion Abundant preparation, proper hemodilution, well cooperation with surgeon, anaethesian, operating nurse and efficient myocardial protection played important roles for successful CPB in early stage open heart surgery. It was also important that monitoring blood gas, electrolyte, urine volume during CPB and postoperative visitation would be strengthened.