体外循环技术用于非心脏外科手术探讨
深低温停循环,,体外循环；深低温停循环；体外膜肺氧合；布加氏综合征；肾癌；基底动脉瘤；气管,1材料与方法,2结果,3讨论,参考文献：
摘要：目的 总结体外循环(CPB)在非心脏外科手术中应用的技术特点及体会，探讨安全有效的方法。方法 回顾39例患者，其中布加氏综合征行根治术29例；颅内巨大基底动脉瘤行夹闭术4例；右肾癌伴下腔静脉瘤栓行右肾及瘤栓清除术2例；气管癌气管梗阻行激光造孔气管内记忆合金成形术2例；气管淀粉样变气管镜下行梗阻疏通术1例；肝脏巨大平滑肌脂肪瘤切除余肝原位移植术1例。CPB技术分别采用深低温停循环(DHCA)26例,其中包括股动-静脉转流(FA-V)未开胸4例；深低温低流量灌注(DHLF)9例；常温静脉-静脉(NHV-V)转流1例；NHV-V体外膜肺氧和(ECMO)呼吸支持2例；常温股动-静脉(NHFA-V)无泵ECMO 1例。结果 CPB转流时间27~231(146.00±41.62)min；心脏阻断时间28~113(56.95±23.02)min；DHCA时间14~63(29.42±11.36)min。低温组最低鼻咽温12.4~20.7(16.78±1.96)℃，最低肛温17.8~25.0(21.57±1.96)℃。35例低温停跳者自动复苏19例(54.28 %)。手术均获得成功，术后早期死亡2例，1例肾癌术后急性肾功能衰竭，另1例布加氏综合征术后2周因应激性溃疡消化道大出血。结论 尽管CPB存在着一定的创伤性、技术性和费用问题，但对某些常规方法不能进行的手术，应用该技术可助手术获得成功。关键词：体外循环；深低温停循环；体外膜肺氧合；布加氏综合征；肾癌；基底动脉瘤；气管
Experience with Cardiopulmonary Bypass in Non-Cardiac Surgery
LI Jia-chun, LUO Jin, WANG Jia-li
(Dpartment of Cardiovascular Surgery General Hospital of PLA, Beijing 100853 China)
Abstract: OBJECTIVE Retrospective study of cardiopulmonary bypass (CPB) technique applied in non-cardiac surgery.METHODS 39 patients including 29 cases of Budd-Chiari Syndrome, 4 cases of intracranial basialis aneurysm, 2 cases of tracheal carcinoma and 1 case of tracheal amyloidosis, 2 cases of large inferior vena cava thrombi from renal carcinoma, and 1 case of leiomys lipoma were operated using CPB technology. Different ways of CPB were adopted as follow: 26 patients received deep hypothermia and circulatory arrest (DHCA) including 4 cases with femoral A-V perfusion without open chest, 9 patients were supported using hypothermia and low flow (DHLF) perfusion, 1 patient using veno-venous bypass in normothermia ......
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