体外循环中心脏复苏困难处理探讨

目的 探讨再阻断控制性温血灌注在心脏复苏障碍时应用。方法回顾性分析35例发生心脏复苏困难患者。(1)体外循环(CPB)方法：采用中度低温，中度血液稀释，4：1血停搏液灌注心肌保护。(2)控制性温血再灌注方法：对21例主动脉开放后ST段抬高患者实施再阻断不停跳温血灌注，14例发生心脏复跳困难患者给予再阻断高钾温血停搏液灌注。结果所有患者均顺利脱离CPB。结论解决主动脉开放后心脏复苏困难，再阻断控制性温血灌注是简单而有效的方法。

Controlled Warm Blood Reperfusion in Difficult Cares of Cardiac Resuscitation During Cardiopulmonary Bypass

OBJECTIVE To elucidate the beneficial effects of controlled warm blood reperfusion in difficulty of cardiac resuscitation. METHODS 35 patients suffered from difficulty in cardiac resuscitation after - clamp release ( 16-75 years old, weights 36 ~ 82kg). Mild hypothermic and hemodilution were used in all cases during CPB. Myocardial protection during ischemia was obtained by 4: Iblood cardioplegia solution. 21 patients with elevated S -T electrocardiogram were reperfused with warm blood, and 14cases with difficulty of cardiac resuscitation were reperfused with high concentration potassium (21mmol/L) warm blood. RESULTS All cases were successfully removed from CPB. CONCLUSION Controlled warm blood reperfusion is effective for patients suffering from difficulty with cardiac resuscitation.