心血管病急诊体外循环策略.docVIP

心血管病急诊体外循环策略 作者:阮秀璇,江国健,郑振雄 【摘要】 　　目的 总结急诊体外循环（emergency extracorporeal circulation,EECC）的经验，探讨EECC在救治心血管病急性事件中的策略。 方法 2001年至2006年间61例心血管病急性事件患者在EECC下行外科手术治疗56例，仅进行心脏辅助循环治疗5例。其中急诊换瓣术20例，急诊冠脉搭桥术7例，大血管手术8例，心脏肿瘤4例，心血管介入治疗失败5例，食道异物累及主动脉3例，先天性心脏病心衰5例，心衰、心跳骤停抢救7例，急性肺动梗塞1例， 急性大出血1例。按EECC前是否进行心肺复苏（CPR）分成A组（11例）、B组（50例），比较分析两组疗效。 结果 全组死亡7例，自动出院3例，存活51例；A组死亡率高于B组。结论 EECC是救治急重症心血管疾病的有效方法，EECC的策略是争分夺秒、加强ECC管理，降低死亡率。 【关键词】 急诊　心血管疾病　体外循环 　　The Strategy of EECC for Emergency Cardiovascular Operation RUAN Xiu-xuan, JIANG Guo-jian, ZHENG Zhen-xiong, LIN Rong,ZHANG He-ying ( Department of Anesthesia,Fujian Provincial Institute of Cardiovascular Diseases, Fujian Fuzhou 350001, China ) Abstract: OBJECTIVE To summarize the experience of EECC and discuss the strategy for the surgical treatment of emergency cardiovascular diseases. METHODS From 2001 to 2006,total 61 cases of emergency cardiovascular diseases were operated including 20 cases of valve replacement,7 cases of CABG,8 cases of great vessel,5 cases of heart tumor,5 cases of failed medical management,3 cases of foreign body injury of aorta,5 cases of heart failure of congenital heart disease，1 case of acute pulmonary embolism，etc. All patients were divided into group A (11 cases) and group B (50 cases) according to with or without cardiopulmonary resuscitation（CPR）before EECC. RESULTS 51 cases survived.7 cases died.3 cases left hospital in dying condition.The mortality rate of group A is higher than that of group B. CONCLUSION EECC is an effective method for emergency cardiovascular surgery.To decrease mortality，the strategy of EECC is faster operation and good management of ECC. Key words： Cardiovascular disease;Emergency extracorporeal circulation 随着心血管病外科的诊疗水平的提高、高难度手术量的增加以及心血管介入治疗的发展，急诊体外循环（emergency extracorporeal circulation,EECC）下心脏手术的数量也明显增多，对ECC技术的要求也越来越高，如何应对这种需求是ECC专业技术人员面临的新课题。作者对本院2001至2006年间的EECC手术进行分析和总结。 　　1 资料与方法