先天性心脏病手术患者52例的体外循环管理

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目的探讨先天性心脏病(先心病)的有效体外循环(ECC)管理方法。方法对52例先心病患者根据病情和手术时间的长短,采用浅低温或者中低温体外循环,中度血液稀释,术中提供满意的灌注流量,重视心肌及各种脏器的保护。结果全组ECC时间44~150 min,主动脉阻断时间28~110min,均顺利停机,术后2例死于低心排综合征。结论根据心脏畸形的复杂程度选择合适的体外循环方法,适当的血液稀释和流量灌注,合理用药,做好心肌和各脏器的保护是减少术后并发症、提高手术成功率的关键。 Objective To investigate the effective cardiopulmonary bypass (ECC) management of congenital heart disease (CHD). Methods Fifty-two patients with congenital heart disease were treated with mild hypothermia or hypothermia cardiopulmonary bypass and moderate hemodilution according to the condition and duration of operation. Satisfactory perfusion flow rate was given intraoperatively to protect the myocardium and various organs. Results The whole set of ECC time was 44-150 minutes and the aortic block time was 28-110 minutes. Both patients stopped smoothly and 2 patients died of low cardiac output syndrome. Conclusions According to the complexity of heart deformity, it is the key to choose appropriate cardiopulmonary bypass method, appropriate hemodilution and perfusion, proper medication and protection of myocardium and organs to reduce postoperative complications and improve the success rate of operation.
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