心脏停跳和不停跳瓣膜置换术体外循环效果比较

目的 探讨心脏停跳（ＡＨ）和不停跳（ＢＨ）瓣膜置换术（ＶＲ）体外循环（ＣＰＢ）管理技术的特点。方法 观察２０１例ＶＲ患者，其中ＡＨ９０例，ＢＨ１１１例。比较两组在ＣＰＢ期间及术后相关指标的改变。结果 两组相比，ＢＨ组转流时间和阻断时间较短，使用库血倒数和库血用量、钾和碳酸氢钠用量、术中失血量等较少（Ｐ〈０．０５）；术后血管扩张剂使用率较高（Ｐ〈０．０５）。结论 心脏不停跳瓣膜置换手术在ＣＰＢ管理方

The Comparison in Management of Cardiopulmonary Bypass with Beating or Arresting Hearts for Valve Replacement

Objective:To explore the differtnce in the management of cardiopulmonary bypass(CPB) while beating or arresting heart in valve re- placements.Methods:201 cases of valve replacenents were subjected into groups with beating - heart(Group BH, n = 111) or arresting - heart (Group AH, n=90 ). The preoperative states and postoperative courses of the patients were compared.Blood gas, serum electrolytes ,urine output during CPB were recorded and analyzed statistically.Results:The operative mortality was 1.8% in Group BH, and 4. 2% in Group AH. There was no bypass - related death in both groups.The amount of administration of potassium and sodium bicarbonate during CPB,and bankblood using in Group BH was much less, but the rate of vasorelaxant administration was higher than that in Group AH. conclusion: Cardiopulmonary bypass with beating - heart for valve replacement is safe and easier to manage.