【摘要】 为介绍体外循环期间动脉大量气栓5例的救治体会，总结经验教训。对患者气栓发生时立即停心肺机，以4．0～8．0kPa压力行上腔静脉及右心房逆行灌注，排净气体。再恢复正常灌注辅助循环。术后辅以高压氧、镇静及大剂量皮质激素等治疗。结果：3例存活，随访1～6年无后遗症；2例死亡。本文结果提示：上腔静脉和右心房逆行灌注能排除脑血管及冠状血管内气体。这对解除或减轻中枢神经系统和心肌损伤、防止严重低心输出量综合征发生、增加心脑复苏机会十分重要，应在气检发生后即刻施行。高压氧可促进施气检吸收，增加脑组织氧供，改善脑损伤后遗症，应在患者循环功能稳定后及早进行。更多还原

【Abstract】 This artical reviewed the management of 5 cases of massive arterial air embolism during cardiopulmonarybypass (CPB). The pump-oxygenator was stopped as soon as the massive arterial air embolism occurred and retrogradeperfusion through superior vena cava (RPSVC) and right atrium was performed immediately. The retrograde perfusionpressures were 4.0~ 8. 0kPa. Normal CPB were per formed afterwards to assist circulation, hyperbaric oxygenation,sedative and large dosage corticoid therapy were used postoperatively. Three patients survived and were followed up for1 to 6 years. No neurological sequelae occurred in them. Two patients died. Retrograde perfusion through superior venacava and right atrium can remove rnost air embolism in the blood vessels of brain and heart to reduce or relief the injuriesand prevent from serious low cardiac output. It is very important for the resuscitation of the brain and heart, and shouldbe used as soon as massive arterial air embolism occurs during CPB. Hyperbaric oxygenation can promote the absorbtionof air embolism in the brain vessels, improve the oxygen supply to the brain tissues and improve neurological sequelae.It should be used as early as patient’s circulatory function is steady.更多还原