摘要
目的总结双侧颈内静脉置管引流用于全胸腔镜不停搏再次三尖瓣手术的经验。方法回顾性分析自2014年3月至2017年3月于广东省人民医院行全胸腔镜不停搏再次三尖瓣手术患者43例的临床资料。全组患者采用静吸复合麻醉,通过双侧颈内静脉和股静脉置管进行静脉引流,股动脉置管进行全身灌注。转流中鼻咽温维持33℃~35℃、平均动脉压50~90 mmHg(1 mmHg=0.133 kPa)。结果 43例患者术中静脉引流效果好,手术视野清晰。未发现与双侧颈内穿刺置管相关的并发症,术后穿刺口愈合良好。结论保证充足的静脉引流维持术野清晰是全胸腔镜下不停搏再次三尖瓣手术的关键;双侧颈内静脉置管引流安全可行。
Objectives To summarize the experiences of bilateral internal jugular vein catheter drainage for totally thoracoscopic beating tricuspid valve reoperation.Methods From Septenber2014to March2017,43patients under?went totally thoracoscopic beating tricuspid valve reoperation in Guangdong General Hospital were selected.All the patients received intravenous inhalation anesthesia.Venous drainage was performed by bilateral internal jugular vein and femoral vein catheterization.Systemic perfusion was performed through femoral artery catheterization.Nasopharyn?geal temperature maintained33℃-35℃and mean arterial pressure maintained50~90mmHg(1mmHg=0.133kPa)during cardiopulmonary bypass.Results Of the43patients,venous drainage was good and surgical field of vision was clear during the operation.No complications associated with bilateral internal jugular puncture were found,and the puncture wound healed well after the operation.Conclusions The key of totally thoracoscopic beating tricuspid valve reoperation is ensuring adequate venous drainage to keep the operation field clear.Bilateral internal jugular vein cathe?ter drainage is safe and feasible.
作者
黄宏前
曾庆诗
HUANG Hong-qian;ZENG Qing-shi(Guangdong General Hospital Zhuhai Hospital,Zhuhai,Guangdong 519040,China;Guangdong Cardiovascular Institute,Guangdong General Hospital,Guangdong Academy of Medical Sciences,Guangzhou 510080,China)
出处
《岭南心血管病杂志》
2017年第6期704-707,共4页
South China Journal of Cardiovascular Diseases
关键词
心脏外科手术
全胸腔镜
颈内静脉引流
不停搏
再次心脏手术
cardiac surgical procedures
totally thoracoscopic cardiac operation
internal jugular venous drainage
beating heart
cardiac reoperation
