体外循环在心脏及大血管损伤急救中的应用

摘要

目的 临床评价体外循环(CPB)在心脏及大血管损伤急救中的应用和疗效.方法 从2003年7月至2010年12月我院急诊应用CPB技术救治创伤所致心脏及大血管破裂患者11例.其中3例为创伤所致心脏穿透伤,3例为创伤所致颈部大血管损伤,4例为肾癌根治术中下腔静脉破裂,1例为肺叶切除术中肺静脉破裂.结果 全组死亡1例(9.1%),为颈部刀刺伤及无名动脉,术前已经出现失血性休克和心跳骤停;其余患者均顺利康复出院.结论 准确的判断,及时有效的术前处理,尽早建立CPB,加强CPB管理,可有效提高创伤所致心脏及大血管破裂的救治成功率.%Objective To evaluate the efficacy of cardiopulmonary bypass ( CPB) in emergency trealmenl for cardiac injury and cardio great vessel Lrauma. Methods A total of 11 cases of cardiac injury and cardio great vessel Lrauma were Irealed emergenlly by cardiopulmonary bypass from July 2003 Lo December 2010 in our center,including 3 cases of cardiac ruplure,3 cases of cervical vascular injury,4 cases of inferior vena cava ruplure during radical nephreclomy and 1 case of pulmonary vein rupture during pulmonary lobectomy. Results one case which experienced hemorrhagic shock and cardiac arrest preoperalively died (9. 1% ) due Lo innominale artery ruplure. The rest cases were recovered and discharged. Conclusion Correct judgement, effective preoperalive emergency Irealmenl, establishing CPB as early as possible and enhancing CPB adminislralion can improve the survival rale for palienls with cardiac injury and cardio greal vessel lrauma.