微创心脏手术中周围体外循环120例总结

目的 :总结分析不开胸的体外循环及心肌保护 12 0例。方法 :对 12 0例胸腔镜心脏手术所采用的不开胸体外循环及心肌保护技术进行回顾分析。全组均采用股动、静脉或加上腔静脉插管建立体外循环 ,右侧胸壁打孔胸腔镜下长阻闭钳阻闭升主动脉 ,冷晶体停跳液顺行灌注保护心肌。结果 :全组无手术死亡病例。术中泵压偏高 8例 ,灌注流量不足 3例 ,术后血红蛋白尿 13例 ,肝功能损害 7例 ,术后右下肢轻度肿胀 3例 ,右下肢局部麻木、疼痛 4例 ,右股动脉处可闻及杂音 3例。结论 :周围体外循环及心肌保护安全、可行。并发症以血红蛋白尿 ,肝功能损害 ,股动、静脉损伤为常见。

Minimally Invasive Cardiopulmonary Bypass and Myocardial in One Hundred Twenty Patients

Objective:To summarize the experience of endoscopic surgery with minimally invasive cardiopulmonary bypass(CPB) and myocardial preservation in 120 cases.Methods:One hundred and twenty patients underwent video assisted cardiac surgery.In this study,the arterial catheter and one of venous catheters were placed in the right femoral artery and femoral vein,another venous catheter was placed in the superior vena cava to set up CPB.The aorta was cross clamped and the myocardium was protected by coronary perfusion with cold cardiopleige.Surgery was done endoscopically.Results:All patients survived surgery.During the operations,pump pressure was higher in 8 patients and inadequate systemic perfusion in 3 patients.Postoperatively,13 patients had hemoglobinuria and 7 patients had abnormal hepatic function.There was mild swelling( n =3)and local pain( n =4) in the right lower extremity.Conclusion:Our experience demonstrates that minimally invasive extracorporeal circulation and myocardial preservation is technically feasible.