摘要
目的探讨术前预存自体血在主动脉夹层(AD)手术中的可行性。方法选取2023年1月至2024年5月北部战区总医院心血管外科收治的70例Stanford A型AD患者,男性51例,女性19例。年龄(47.18±11.57)岁,年龄范围为32~74岁。麻醉后由中心静脉鞘管、枸橼酸钠抗凝回收自体全血,同时经其他外周静脉给予碳酸钠林格晶体注射液及琥珀酰明胶注射液扩容,分析围术期各项参数。结果患者的体外循环时间为(157.16±31.89)min,主动脉阻断时间为(88.22±24.53)min,停循环时间为(5.87±2.99)min,最低鼻咽温度为(29.24±1.26)℃,最低肛温为(31.46±1.53)℃,预存自体血(767.14±195.46)ml,术后24 h引流量(185.77±75.29)ml,术中回输后红细胞压积(27.70±2.14),术后住院时间(13.10±5.19)d。术后无患者进行二次开胸止血。死亡2例、自动出院4例、二次插管1例、术后脑梗4例、术后因心源性休克置入体外膜肺氧合1例。结论预存自体血回输技术在AD手术中安全可行。
Objective To investigate the safety and feasibility of preoperative autologous blood in aortic dissection surgery.Methods 70 patients with Stanford type A aortic dissection were enrolled from January 2023 to May 2024.Autologous blood was recovered by central venous and anticoagulation with sodium citrate.Intravenous fluids were administered to replenish the volume.Perioperative parameters were recorded.Results Extracorporeal circulation time was(157.16±31.89)min.The time of occlusion of the aorta was(88.22±24.53)min.Circulatory arrest time was(5.87±2.99)min.The losted temperature of the nose and throat was(29.24±1.26)℃.The losted temperature of anorectum was(31.46±1.53)℃.Prestorage of autologous blood was(767.14±195.46)ml.The volume of Postoperative drainage in 24 h was(185.77±75.29)ml.The hematocrit after transfusion was(27.70±2.14).Length of postoperative hospital stay(13.10±5.19)d.No secondary thoracotomy was performed,two cases died,the number of withdrawing treatment patients were four,the number of second tracheal intubation was performed was one,Patients with Cerebral Infarction were four,extracorporeal membrane oxygenationwas implanted in 1 patient due to cardiogenic shock.Conclusion Prestored autologous blood and transfusion is safe and feasible in aortic dissection surgery.
作者
王斌
石云
姜雨涵
屈晓宇
刘宇
WANG Bin;SHI Yun;JIANG Yu-han;QU Xiao-yu;LIU Yu(Department of Cardiovascular Surgery,General hospital of Northen Theater Command,Shenyang 110016,China)
出处
《创伤与急危重病医学》
2024年第6期345-347,共3页
Trauma and Critical Care Medicine
