15例法乐四联症手术的体外循环管理

目的对15例法乐氏四联症(TOF)根治术患者的体外循环(CPB)术中管理进行回顾性总结。方法15例中男10例,女5例,年龄5～28岁,体重16～57kg,11例采用中低温中高流量,4例采用深低温低流量,10例用冷晶体停跳液灌注,5例用4∶1冷氧合血停跳液灌注。转流前静脉放血4例,转流中超滤4例。结果除1例因术后重度低心排综合征加上肺部感染死亡外,其余患者均治愈出院。结论针对TOF的特点,选用合适的体外循环方法,对手术成功具有重要作用。

Management of cardiopulmonary bypass in tetralogy of fallot operations;Areport of 15 cases

Objective 15 tetralogy of Fallot cases cardiopulmonary bypass peri-operative management were reviewed retros pectively.Methods Among 15 cases,10 patients were male and the other 5 female.Age from 5 to 28 y.o.weight 16~57 kg.11 cases adopted mild hypothermia with mild and high flow.4 cases adopted deep hypothermia and low flow.10 cases adopted cold crystalloid cardioplegia perfused and 5 cases perfused with 4 ∶1 cold oxygen-containing blood cardioplegia.Some blood was bleeding through the vein draining tube before bypass in 4 cases and ultrafiltration used during bypass in 4 cases.They achieved fairly good.Results One patient died of post-operative severe low cardiac output and respiratory infection.All other patients were successfully treated and discharged.Conclusions Suitable selection of the method of cardiopulmonary bypass determines the outcome and prognosis after surgery.