急诊体外循环在心血管外科中的应用37例观察

目的分析总结37例急诊体外循环手术（emergency cardiopulmonary bypass,ECPB）的疗效及经验,探讨ECPB在临床中的作用及应用指征.方法昆明市延安医院2000年3月至2009年8月期间共施行了ECPB手术37例.其中急诊冠状动脉旁路移植术9例,大血管手术4例,心脏瓣膜功能不全7例,心脏肿瘤3例,心内膜炎伴赘生物形成行瓣膜替换术2例,法洛四联症急性缺氧发作行矫治术3例,先天性心脏病介入治疗失败急诊术7例,外伤性心脏破裂2例.结果术后存活33例,手术成功率89%.结论 ECPB对心外科急危重患者的救治是一种非常有效的治疗措施,有时甚至是唯一方法,但需掌握急诊手术的指征,快速建立体外循环,多科协作,以提高手术成功率减少术后并发症。

Application of Emergency Cardiopulmonary Bypass in Cardiovascular Surgery

Objective To evaluate the effect of emergency cardiopulmonary bypass and to discuss its indications and summarize the experience of ECPB.Methods From March 2000 to August 2009,total 37 cases of emergency cardiopulmonary bypass were operated,including 9 cases of CABG,4 cases of surgery on great vessels,7 cases of heart valve disorders,3 cases of heart tumor,2 cases of valve replacememt because of endocarditis and vegetations,3 cases of TOF,7 cases of congenital heart disease,2 cases of traumatic cardiac rupture.Result In 37 patients,33 patients survived,and the success rate of surgery was 89%.Conclusions ECPB is an effective method for emergency cardiovascular surgery,but should be based on the indications.The success rate of surgery can be improved and the complications after surgery can be reduced by establishing ECPB as soon as possible.