【摘要】 目的探讨已停跳供心原位心脏移植体外循环管理的方法和经验。方法47例终末期心脏病患者采用升主动脉及上、下腔静脉插管;采用中度低温(鼻咽温28.1～29℃),轻-中度血液稀释(血红蛋白82～119g/L),60～90ml/(kg.min)的流量进行体外循环灌注;供心保护方法:先采用1000ml8℃的HTK液首次直接灌注心脏,供心切下后,将供心放到套有无菌塑料袋的无菌器皿中继续将剩余量的4℃HTK液灌完,流出的HTK液可用来浸泡供心。结果47例均顺利脱离体外循环机,术后康复出院。结论合理的灌注技术及良好的心肌保护,可使已停跳供心的原位心脏移植获得成功。更多还原

【Abstract】 Objective To study the methods and experience of cardiac arrest orthotopic heart transplantation extracorporeal circulation management.Methods Forty-seven cases of patients with end-stage heart disease applied ascending aorta,and vena cava intubation;the requirement of extracorporeal circulation perfusion:moderate use of low-temperature(nasopharyngeal temperature 28.1~29℃),light-moderate hemodilution(hemoglobin 82~119 g/L),60~90 ml(kg·min);Methods for heart protection:First the heart was perfused with 100 ml of 8℃ directly,then it was cut and put into a sterile container which was covered with a sterile plastic bag,and continued to be perfused with the remaining 4℃ HTK.Finally,the heart was soaked with the outflowing HTK.Results Forty-seven patients were successfully from the CPB machine,after recovered and were discharged.Conclusion Reasonable infusion of technology and good myocardial protection is successful for cardiac arrest orthotopic heart transplantation.更多还原