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心脏不停跳下心脏换瓣术的麻醉与灌注
AnesthesiaandperfusionofheartvalvereplacementunderCPBwithbeatingheart
【摘要】 芬太尼-安氟醚静吸复合麻醉,高流量心肺转流同时应用自行设计的灌注装置,经冠状静脉窦逆行灌注,在心脏不停跳的状态下进行主动脉瓣置换术,然后改为顺行灌注,再行二尖瓣置换术或其它合并症的矫治,治疗风湿性心脏病病人12例。术中麻醉平稳,灌注满意,阻断主动脉前后的血气分析、电解质、心肌酶的测定无明显变化,术后无多巴胺等正性肌力药物依赖和严重心律失常,恢复良好,提示该麻醉和灌注方法具有良好的心肌保护作用。
【Abstract】 Twelvecaseswithrheumatismoftheheartweretreatedunderfentanyl-enfluraneanes-thesiaandCPBwithbeatingheartandhighperfusionflow.Firstofal,Theaorticvalvereplacementwasperformedundercoronarysinusretrogradeperfusion.Thenthemitralvalvereplacementorcorrectionwasdoneundernormalanterogradeperfusion.Thestateofanesthesiaandperfusionwassatisfactoryduringoperation.Thebloodgas,acid-base,electrolytesandmyocardialenzymesdeterminationsdidnotchangesignificantlybeforeandafteraorticclamp.Therewerenodopaminedependenceandseverear-rhythmiaafteroperation.Alpatientsrecoveredsmoothly.Theresultsindicatethattheabovementionedtechniqueisefectiveformyocardialprotection.
- 【文献出处】 中华麻醉学杂志 ,CHINESE JOURNAL OF ANESTHESIOLOGY , 编辑部邮箱 ,1996年11期
- 【分类号】R614:RR654.2
- 【被引频次】23
- 【下载频次】49