【摘要】 目的 :探讨心脏不停搏心内直视手术的体外循环技术和管理特点。方法 :回顾性分析 114例心脏不停搏心内直视手术的体外循环方法及管理。术中严密监测血气分析、电解质变化 ,并及时进行调整 ,鼻咽温度控制在 32℃左右 ,灌注流量在 90～15 0ml·kg-1·min-1。结果 :体外循环过程中血液动力学平稳 ,心肌保护效果较好 ,患者均顺利脱离体外循环机 ,且术后各项生命体征及一般情况平稳。结论 :心脏不停搏心内直视手术体外循环过渡宜力求平稳 ,避免温度变化造成心律失常 ,采用高流量灌注确保各重要脏器的血液供应 ,不存在心肌再灌注损伤 ,可取得良好的组织灌注效果 ,有利于心肺脑保护更多还原

【Abstract】 Objective:To probe into the tecniques of extracoporeal circulation in intracordal orthophoric operation without heart stopping subsultus.Methods:One hundred fourteen cases receiving extracorporeal circulation of intracordal orthophoric operation without heart stopping were analysed retrospectively.Blood gas analysis and the change of electrolyte were observed closely and adjusted properly.The nasopharyngeal temperature was controled at 32℃ approximately and the flow of perfusion was 90 to 150 ml·kg -1 ·min -1 .Results:In the process of extracorporeal circulation,the hemodynamics of the patients was stable and the effect of myocardium protection was good,all patients were favorable for sublation extracorporeal circulation and the vital signs and general condition were stable after operation.Conclusions:We should lay emphasis on stability in extrocorporeal circulation of intracordal orthophoric operation without heart stopping subsultus.Arrhythmia caused by temperautre change should be avoided.In order to ensure the blood supply for important visceras,the high flow of perfusion should be adopted.As there is no danger of reperfusion damage for myocardium,it is favourable for the protection of the heart,lung and brain.更多还原