【摘要】 目的总结分析老年患者心脏手术的体外循环管理经验。方法回顾性分析我院73例65岁以上老年患者实施体外循环心脏直视手术的临床资料,全部患者体外循环过程中采用中度血液稀释、浅低温、高流量灌注,低温氧合血进行心肌保护,常规应用超滤。结果体外循环时间31~209 min(平均78.4 min),阻断升主动脉时间21~103 min(平均45.7 min),心脏自动复跳57例(78%),术后1例患者死于低心排综合征。结论选择优质膜肺、适度稀释血液、采用高灌注流量、加强心肌保护、仔细做好术中监测、合理应用超滤,可为老年患者心脏手术成功提供重要保障。更多还原

【Abstract】 【Objectives】To summarize the experience of cardiopulmonary bypass(CPB) in elderly patients underwent cardiac operation. 【Methods】We retrospectively analyzed the clinical data of 73 elderly patients underwent cardiac operation with CPB. During CPB, medium hemodilution, high flow, mild hypothermia, cold blood cardioplegia and ultrafiltration technique were applied in each patient.【Results】The CPB time was 31~209 min(mean 78.4 min). Aortic cross-clamp time was 21~103 min(mean 45.7 min). One case died of low cardiac output syndrome. 【Conclusions】High-quality membrane oxygenator, proper hemodilution, effective tissue perfusion, myocardial protection, ultrafiltration technique and other comprehensive measures may help to improve and secure the cardiac operation in elderly patients.更多还原