剖腹产术合并大血管手术体外循环管理

目的:总结剖腹产术合并大血管手术体外循环管理体会。方法:1例主动脉夹层、高血压3级(极高危组)、宫内孕35 w、左肾切除术后及室上速射频消融术后的患者经药物治疗无效,妇科先行剖腹产、子宫切除术,妇科术毕,在体外循环下,行升主动脉替换及Sun's术。结果:患者术后12 h清醒,39h拔出气管插管,手术后母婴平安,孕妇顺利恢复。结论:针对大血管手术的方式选择体外循环方法,根据孕妇的生理特点,合理制定体外循环计划,以减少患者的并发症,提高手术的成功率。

The experience of extracorporeal circulation for operation on great artery and pregnancy

Objective:To summarize the experience of extracorporeal circulation for operation on great artery and pregnancy.Methods:One patient with aortic dissection、hypertension of 3 degree(high risk group)、pregnancy for 35 weeks、afteroperation of left nephrectomy and supraventricular tachycardia radiofrequency ablation treated by drug failed to recover,firstly department of gynecology implemented cesarean section,then to implement the replacement of ascending aorta and SUN’S operation.Results:The paitent was awake 12 hours after operation.and pulled out trachea cannula after 39 hours.The patient and her baby were safe and secure afteroperation,the gravida recovered successfully.Conclusion:In order to decrease the complications and ensure successful operation,extracorporeal circulation must be given according to the method of operation on great artery.