体外循环英文版.ppt

体外循环病理生理改变Pathophysiological changes after bypass 1,代谢改变：酸中毒metabolic changes: acidosis 2,电解质紊乱：低血钾electrolytes turbulence: hypokalemia 3,血液破坏：血细胞破坏、凝血因子破坏blood damage: blood cell damage,cloting factors damage 4,肾和肺功能的破坏renal or lung function decrease or damage 思考？Thinking: 怎么减低心肌缺血性损害 How to reduce the myocardial injure ？ Thanks * 体外循环 Cardio-pulmonary Bypass 什么是体外循环？ What is cardiopulmonary Bypass? 为什么需要它？ Why we need it? 大多数心内畸形的修补需要无血静止的手术环境To repair most cardiac defects, the cardiothoracic surgeon requires a bloodless, motionless field in which to work 为达到此目的需要心肺停止工作 To achieve this, the motion of the heart and lungs must be stopped. 需要解决以下问题 There needs to be a way or process: 1, 血液循环继续进行 for blood to circulate throughout the body, 2, 血液必须进行气体交换 for blood to have gas exchanging, while the heart and lungs are not working 体外循环可以解决上述问题 ----To replace the works of heart and lungs This is made possible through a process known as cardiopulmonary bypass (CPB). In this way, cardiopulmonary bypass can provide the desired bloodless, motionless operative field and still supply all the other organs of the body with oxygen and nutrient-rich blood. 小结： Summary for CPB: 1,目的purpose: A, 提供无血安静的手术野to provide a bloodless, motionless field for heart surgery; B, 在心肺停止工作期间保持机体有良好的血液灌注rest of body perfused while heart and lung stopped 2,方法methods: A, 把静脉血引出体外drain out venous blood B, 通过人工肺进行氧合oxygenated by artificial lung C, 含氧血通过人工心再灌注回机体oxygen-rich blood pumped back by artificial heart 基本设备Basic equipment 1, 人工心（血泵）artificial heart (blood pump) 2,人工肺（氧合器）artificial lung (oxygenator) 3, 温度交换器temperature exchanger 4,滤器filter 5,管道和插管tubes or cannulas Temperature exchanger, artificial lung artificial lung artificial heart bypass machine 3:典型的体外循环过程 Typical cardiopulmonary bypass process for open heart surger