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目的:总结11例大动脉调转术(ASO)体外循环转流的方法与经验。方法:均在全麻体外循环下行ASO,通过实施中低温,改良预充液,联合应用常规超滤(CUF)、零平衡超滤(ZBUF)及改良超滤(MUF)技术,保护患者心、脑、肺、肾、血液等重要器官功能。结果:2例患者死于术后低心排血量,余9例患者均存活,体外循环期间血流动力学基本稳定,血气电解质维持在正常范围,术后彩色多普勒超声心动图示左、右心功能较术前明显改善,顺利康复出院。结论:改良预充液,中低温全流量灌注,良好的心肺和血液保护;CUF、ZBUF及MUF联合应用,保持机体内环境稳定是ASO体外循环管理的关键。
Objective: To summarize the methods and experience of 11 cases of aortic bypass (ASO) during cardiopulmonary bypass. Methods: ASO was performed under cardiopulmonary bypass with general anesthesia, and the patients were protected by using medium and low temperature modified priming solution, combined with conventional ultrafiltration (CUF), zero balance ultrafiltration (ZBUF) and modified ultrafiltration (MUF) Brain, lung, kidney, blood and other important organ functions. Results: 2 patients died of postoperative low cardiac output, more than 9 patients survived during cardiopulmonary bypass hemodynamic stability, blood gas and electrolyte remained in the normal range, postoperative color Doppler echocardiography showed left , Right heart function improved significantly compared with preoperative, successful rehabilitation. CONCLUSION: The combination of CUF, ZBUF and MUF improves the preconditioning, the middle and low temperature full flow perfusion, the good cardiopulmonary and blood protection. Maintaining the stable environment in the body is the key to ASO management.