【摘要】 目的评价体外静脉-静脉压差式转流在上腔静脉置换术中的临床应用价值。方法选取2004年~2006年我院实施上腔静脉切除人造血管重建术无神经系统合并症的患者。术中应用体外静脉-静脉压差式转流。术中持续监测动脉血压、颈内静脉压。于转流前、转流后、阻断后5min、15min、40min及开放后5min、1h经颈内静脉、桡动脉同时抽血行血气分析。术毕随访呼唤睁眼时间及神经系统相关并发症。结果术中动脉血压无变化。阻断期间颈内静脉压升高,平均动脉压与颈内静脉压差及颈内静脉氧饱和度(SjvO2)下降。开放后上述三者均迅速恢复至基础水平。所有患者术毕呼唤睁眼,无神经系统并发症发生,痊愈出院。结论体外静脉-静脉压差式转流操作简单、无污染、可控性好,易维持稳定的血流动力学,改善了脑的血液灌注,是一种安全有效的脑保护临床措施。更多还原

【Abstract】 Objective:To evaluate the efficacy of extracorporeal jugular-femoral vein bypass during superior vena cava(SVC)reconstruction.Methods:A total of 13 patients without neural complications undergoing elective resection and reconstruction of superior vena cava were enrolled.And extracorporeal jugular-femoral vein bypass was used.The arterial pressure and jugular vein pressure were continuously monitored during operations.The arterial and jugular vein blood gas analysis were measured at different time points.Results:There was no significant differences in arterial blood pressure during operations.During SVC clamping,jugular vein pressure increased,jugular vein blood oxygen saturation(SjvO2)and mean arterial-jugular vein pressure difference decreased significantly as compared with those before SVC clamping(P<0.05).None of the patients involved any neurologically injured signs and symptoms.Conclusion:Extracorporeal jugular-femoral vein bypass can maintain stable homodynamic,and improve brain perfusion,which is safe,easy and efficient for SVC reconstruction surgery during temporary SVC clamping.更多还原