摘要
目的探讨在主动脉弓部手术中采用双侧序贯顺行性脑灌注技术对中枢神经系统的保护作用。方法24例主动脉弓部手术患者，采用右腋动脉插管或同时行右股动脉插管，术中深低温停循环时右侧单侧顺行脑灌注，继以双侧脑灌注，硌要时再改为左单侧脑灌注保护，观察患者术后恢复情况及中枢神经系统并发症的发生情况。结果死亡2例，分别死于顽固性低心排出量综合征和迟发性消化道大出血，均非严重中枢神经性并发症致死；存活患者严重脑部并发症。结论结合深低温停循环的双侧序贯顺行性脑灌注技术，可以为主动脉弓置换手术提供良好的中枢神经系统保护。
Objective To study the brain protection of sequential double-sided antegrade cerebral perfusion to central nervous system in arotic arch surgery. Methods 24 patients received aortic arch replacement under deep hyperthermic circulatory arrest （DHCA） , with right-sided, and following double-sided, and left-sided, if necessary, antegrade cerebral perfusion through right axillary arterial cannula or right femoral arterial cannula homeochronously. Post-operation recovery and the central nervous complications （CNC） were recorded and analyzed. Results 2 cases died ,one of whom died of refractory low cardiac output syndrome and the other died of late massive gastrointestinal tract hemorrhage. No patient suffered severe CNC. Conclusion Sequential double-sided antegrade cerebral perfusion combined with DHCA can provide good brain protection in arotic arch replacement.
出处
《中国综合临床》
北大核心
2008年第8期816-818,共3页
Clinical Medicine of China
关键词
主动脉弓部手术
顺行性脑灌注
深低温停循环
脑保护
Arotic arch surgery
Antegrade cerebral perfusion
Deep hyperthermic circulatory arrest
Brain protection
