升主動脈假性動脈瘤手術(shù)體外循環(huán)的體會

1、鍗囦富鍔漢剦鍋囨？y姩鑴夌槫鎵嬫湳浣撳寰 幆鐨勪紘浼？/center 浣滆？咃細閮穽鑼冨叏蹇？閭規(guī)擴浼？閮 叞鏁?/p 銆愬叧閿瘝銆？/stron g浣撳寰幆 銆？銆？鍏抽敭璇嶏細鍗囦富鍔以剦鍋囨？y姩鑴夌槫錛涗綋澶栧驚鐜紱娣 變綆娓+紱浣庢祦閲忥紱鍋滃驚鐜？ 銆？銆？鍦厶崌涓誨姩鑴夌槫涓紝鐪熸 鎰忎篦涓婄兢鍋囨？y 姩鑴夌槫騫 朵笉澶氳錛屽浗鍐呮枃鐚姤鍛婄兢涔熶笉澶氥？傛垜浠粠1995锝？003 騫村叡鏀舵不浜嗗崌涓誨姩鑴夂亣鎬y姩鑴夌槫4渚嬶紝騫撮緞鏈？灝？9宀 侊紝鏈？澶？0宀侊紝4渚嬪潎閲囩敤鍙充晶鑲姩闈欒剦鎖掔寤虹珛浣撳 寰 幆錛？3渚嬫繁浣庢俯銆佷綆嫻侀噺錛？渚嬫繁浣庢俯銆佸仟寰幆

2、錛涙墜 鏈浜？渚嬶紝鍏朵綑鐥呬漢鎭鑹，銆傛垜浠涓猴紝鍗囦富鍔以 剦鍋囨？y姩鑴夌槫鎵嬫浦瀹滈？夋嫨鑲姩闈欒剦鎖掔浣撳寰幆錛涙 繁浣庢俯銆佷綆嫻侀噺鎴栧仟寰幆瀵規(guī)墜鏈槸瀹夂叏鍙潬鐨勩？/p 銆？銆？1涓村簥璧勬枡涓庢柟娉？/strong 銆？銆？1.1涓村簥璧勬 枡 銆？銆？鏈粍4渚嬬梾渚？鐢?濂籌紝璇姘y ?quot;銆備綋澶栧驚鐜繃紼嬩腑錛屾瘡 闅?030min瑕佹煡琛？姘斿垎鏋愶紝緇存寔 PaC023545mmHg,Pa02200300mmHg,pH7.357琛5,涓村簥璧勬枡錛堢暐 錛?br / 銆?銆？3.3娣變綆娓+仟寰幆鏃惰娉兒剰鑽墿鐨勤 緇忎繚鎶拰 鍋滃驚鐜 兢鏃墮檺錛岄暱鏈熷仟

3、寰幆鍙 垎嬈。繘琛屻？傛浦涓澶撮 儴灞？閮厶啺甯介檷娓+ ?佺敕闇查唶鑴辨按銆佺敳錯哄己鍦版澗榫欑口瀹氱 粏鑳?yōu)鑶溿€傞伩鍏嶆按鑲跨兢鍙八竴涓噸瑕佹帾鏂芥槸鎺掗櫎澶氫綑鐨勬按 鍒嗭紝琛？娑茶秴婊櫒鐨勫簲鐢兒湁寰堥噸瑕佺兢浣滅敤銆傚畠鍙湁鏁蝸 湴嫻撶緝?。挎对尲屾i愰珮??？鐞冨帇縐拰鑳朵綋娓楅？懺帇銆傚鏋滄墜 鏈 鏉傦紝浣撳 寰 幆鏃墮棿闀匡紝鍙粡涓婅厰闈欒剦鎖掔閫嗚 鑴 戠亴娉紝浣嗚娉兒剰鐏屾敞鐨勫帇鍔涚淮鎸佸湪2025mmH錛岃秴 榪？0mmH鍗蟲湁寮疊搗鑴戞按鑲跨兢鍗遍櫓錛岃 ？屼綆浜？5mmH鏃訛紝鑴戜 繚鎶晥鏋滄槑鏄懼噺浣庯薊 5錛姐？?/p 銆?鍙傝？冩枃鐚細 銆？銆？錛 ？錛絊 zen

4、tpetery S, Crisler C, Grinnan GL, et al. Deep hypothermic arrest and leftthoracotomy for repair of difficult thoracic an eurysms錛籎錛? Ann Thorac Surg,1993,55830-833. 銆?銆?錛 ？錛芥潕浣蟲槬錛屾潕鍔熷畫.浣撳寰幆鐏屾敞瀛1薊M錛?鍖 椾含浜烘皯鍐涘尰鍑虹増紺?993錛?23225. 銆？銆？錛？錛紾 rep RB, Ergin MA, Lansman JL, et al. The physiology of hypothemic

5、circulatory arrest錛籑 錛? Seminer Thorac Cardiovasc Surg, 1991,3,188-193. 銆？銆？錛 ？錛紻 eeb GM, Jinkims E, Bolling SF, et al. Retrograde cerebral perfusi on duri ng hypothermic circulatory arrest reduces n eurologic morbidity 錛籎錛? J Thorac Cardiovasc Surg, 1995,109,259268. 銆？銆？錛 ？錛絅 ojima T, Magara Tm Nakajima Y, et al. Optimal perfusi on pressure for experime ntalretrograd