摘要：目的 回顾52例瓣膜病变合并肝功能不全的行瓣膜置换术的患者，总结体外循环(CPB)经验。方法 CPB采取中度低温，保持较高的灌注压力。预充液加入白蛋白。心肌保护用高钾含血停搏液灌注。结果 结果 CPB时间50~135min，主动脉阻断23~98min，心脏自动复跳率94%，无全心辅助和左心辅助，围术期死亡6人。结论 术中加强心肌保护的同时重视肝保护，可减轻术后心功能衰竭和肝功能衰竭，降低并发症和死亡率。

    关键词：体外循环；瓣膜置换术；肝功能不全

    Management of Cardiopulmonary Bypass in Heart Valve Replacement of Patients with Liver Dysfunction

    Zhang Feng-ying1, Gao Yang, Wang Li, Wang Jian-qing, HE Wen-fabg

    1.Cardiac Surgery of Beijing Chuiyangliu Hospital，Beijing 100022，2.Department of Cardiothoracic Surgery of Datong 5st Hospital, Datong 037006,China)

    Abstract: OBJECTIVE To review the experience of 52 patients with heart valve diseases assciated with liver dysfunction undergoing cardiopulmonary dypass(CPB).METHODS Moderate hypothermia and maintaining higher infusion pressure were used during CPB. Albumin was added into the prime before CPB,blood cardioplegia was used for myocardial protection in all patients. RESULTS CPB time rangde from 50 to 135 min, the aortic clamped time rangde from 23 to 98 min. Resustitation of heart was 94%. 6 patients died in perioperation.CONCLUSION Strengthening myocardias protection and liver protection can reduce postoperative heart failure and liver failure, mortality and morbidity. ......