【摘要】 目的：探讨对不同部位、不同病变程度的主动脉瘤的体外循环方式的选择。方法：本组在体外循环下行主动脉瘤外科手术５６例，其中升主动脉瘤３８例，降主动脉瘤１８例。采用低温全身体外循环３１例；左心转流１５例；深低温停循环１０例，其中深低温停循环上腔静脉逆行灌注脑保护方法９例。结果：术中死亡１例，为巨大升主动脉瘤，因吻合口不能控制出血而死亡。术后死亡３例，１例为突发心室颤动，１例为术中大量气体进入主动脉，术后昏迷、肾功能衰竭死亡，第３例为降主动脉瘤术后突发心肌梗死。除１例因动脉插管进入夹层，在开始体外循环时即血压下降、心跳停止，以及术后长时间有神经精神症状外，其余病例均无神经系统并发症。结论：主动脉瘤手术的体外循环方式要根据病变情况决定。更多还原

【Abstract】 Objective:To study the selection of different cardiopulmonary bypass(CPB)patterns according to the location and lesion of aortic aneurysm. Methods:A total of 56 patients with aortic aneurysm were surgically treated.Among them,38 were of ascending and 18 of descending aortic aneurysm,CPB was used in 31,left heart bypass in 15,and deep hypothermia circulatory arrest in 10,in which 9 were combined with retrograde perfusion through the superior vena cava to portect the brain. Results:One patient died on table due to irreversible anastomotic bleeding.Three patients died after operation with the cause of sudden ventricular fibrillation(1),renal failure(1)and acute myocardial infarction(1).Among the survivals,there were no nervous complications except one due to the insertion of the aortic cannula into the false cavity with low blood pressure and cardiac arrest at the initial period of CPB. Conclusion:For aortic aneurysm correct CPB method should be selected according to the lesions.更多还原