摘要
目的探讨选择性心脏灌注技术用于Stanford B型主动脉夹层手术的安全可行性。方法 2019年3月至2020年1月11例Stanford B型主动脉夹层患者采用选择性心脏灌注技术在心脏不停跳下行象鼻支架置入手术,回顾性分析围术期各种参数。结果平均体外循环时间(118.45±26.11)min;心脏选择性灌注时间(28.91±9.04)min;停循环时间及选择性单侧脑灌注时间(22.55±3.59)min;术后呼吸机应用时间(23.64±7.87)h;术后重症监护室滞留时间(2.23±0.65)d;术后住院时间(12.4±2.8)d;围术期输血2例(18.2%);平均住院费用(13.76±0.82)万元;术后超敏肌钙蛋白T(246.33±86.52)ng/L。术后未出现二次开胸止血,切口完好,无围术期死亡。结论选择性心脏灌注技术用于Stanford B型主动脉夹层手术是安全可行的。
Objective To explore the application of selective cardiac perfusion in the management of extracorporeal circulation(ECC) for Stanford type B aortic dissection. Methods A retrospective analysis was conducted on 11 patients with Stanford type B aortic dissection from March 2019 to January 2020. Selective cardiac perfusion technique was used for elephant trunk stent implantation under beating heart. Perioperative parameters were recorded and analyzed retrospectively. Results The average ECC time was 118.45±26.11 minutes;selective cardiac perfusion time was 28.91±9.04 minutes;circulatory arrest time and selective unilateral cerebral perfusion time was 22.55±3.59 minutes;ventilation time was 23.64±7.87 hours;ICU stay was 2.23±0.65 days;perioperative blood transfusion was performed in 2 cases(18.2%);hospital expenses was 137.6±8.2 thousand yuan;postoperative hypersensitive troponin T(TNT-HSST) was 246.33±86.52 ng/L. No second thoracotomy for hemostasis was observed, the incision was intact, and there was no perioperative death. Conclusion Selective cardiac perfusion technique is safe and feasible in the management of ECC for Stanford type B arotic dissection, which can avoid myocardical ischemia reperfusion and shorten the time of ECC.
作者
王斌
刘宇
石云
肖雄
姜辉
Wang Bin;Liu Yu;ShiYun;Xiao Xiong;Jiang Hui(Department of Cardiovascular Surgery,General Hospital of Northen Theater Command,Liaoning Shenyang 110016,China)
出处
《中国体外循环杂志》
2022年第1期8-10,共3页
Chinese Journal of Extracorporeal Circulation
基金
辽宁省自然科学基金(2020-KF-12-01)
辽宁省重点研发计划(2020JH2/10300161)
辽宁省兴辽英才计划(XLYC2007053)。
关键词
选择性心脏灌注
B型夹层
体外循环
心肌保护
Selective cardiac perfusion
Stanford type B aortic dissection
Extracorporeal circulation
Myocardial protection
