体外循环技术在非心脏外科手术及急诊抢救中的应用

目的总结体外循环在非心脏外科手术及急诊抢救中的应用经验,旨在进一步拓宽体外循环技术在综合医院多学科领域里的应用范围。方法 2005年1月～2012年3月共完成的9例体外循环技术在非心脏外科手术及急诊抢救中的应用。4例采用股-股转流技术,1例采用升主动脉-上下腔静脉插管转流技术,2例分别采用降主动脉和右心房插管输血技术,2例分别采用升主动脉与股静脉和升主动脉与上腔静脉+股静脉插管转流技术。结果 9例体外循环转流顺利实施,体外循环时间17～180 min,3例阻断时间29～46 min,8例手术及急救成功,术后顺利康复出院,1例心脏骤停的冠心病患者抢救无效,心脑复苏失败,死亡。结论体外循环技术的应用,使传统方法难以完成的高难度非心脏外科手术获得成功,也为非心脏外科手术术中大出血的急诊抢救提供新的救治手段。

The utilization of cardiopulmonary bypass technique in non-cardiac surgery and emergency rescue

Objective To summarize the experience of the utilization of cardiopulmonary bypass （CPB） technique in non - cardiac surgery and emergency rescue, and to broaden the range of usage of CPB technique in multi - disciplinary fields of general hospital. Methods There were 9 cases of non - cardiac surgery and emergency rescue with CPB technique from January 2005 to March 2012. Four of them employed femoral artery - femoral vein bypass technique, and 1 of them with ascending aorta - superior vena cava and inferior vena cava intubation bypass technique. Respectively, 2 of them with intubation blood transfusion technique between descending aorta and right atrium, 2 of them with intubation bypass technique between ascending aorta and femoral vein and between ascending aorta and superior vena cava and femoral vein. Results Nine operations with bypass technique successfully implemented. The duration of using bypass technique was from 17 minutes to 180 minutes. Blocking time was 29 minutes to 46 minutes in 3 surgeries. 8 Patients received rehabilitation after operations and emergency rescue. One patient with cardiac arrest died. Conclusion Difficult non - cardiovascular surgeries achieved success because of the utilization of the bypass technique, which were not easy to succeed with traditional methods. It is not only a new treatment measure for emergency blooding in non - cardiovascular surgeries, but also to broaden the range of noncardiovascular surgeries, to increase the indications of operations and to improve the safety of operations. This technique is also a method to provide life support for patients with heart failure. In addition, it will save treatment time for the rehabilitation of heart function.