Simple hypothermic retrograde cerebral perfusion during aortic arch surgery.
Simple hypothermic retrograde cerebral perfusion during aortic arch surgery.
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主动脉弓手术期间简单的低温逆行脑灌注。
DOI：
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发表时间：
1992
期刊：
影响因子：
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通讯作者：
S. Miyata
中科院分区：
文献类型：
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作者：
S. Takamoto;T. Matsuda;M. Harada;Y. Shimamura;S. Miyata
我们发现在主动脉弓手术中通过简单地升高中心静脉压可以进行逆行脑灌注。在低温（15摄氏度）时，富含氧气的静脉血灌注大脑，而身体的下半部分则被灌注，降主动脉闭塞。本文报告了14例主动脉弓部动脉瘤患者（男11例，女3例）的手术效果。行正中开胸6例，侧开胸8例。脑循环停止时间为65 +/- 14 min（32-93 min），在脑中观察到显著的氧和乳酸提取。11例无神经功能缺损，3例因其他原因出现意识丧失。总之，这种方法保持了大脑的有氧代谢，并在长时间的脑循环停止过程中保护它，简化了程序，并允许正中和外侧入路。
We have found that retrograde cerebral perfusion can be performed by simply elevating central venous pressure during aortic arch surgery. During hypothermia (15 degrees C) venous blood rich in oxygen perfuses the brain, while the lower half of the body is perfused with the descending aorta occluded. Fourteen cases of aortic arch aneurysm (11 males, 3 females) were treated by this method and evaluated. Median and lateral thoracotomies were performed in 6 and 8 cases, respectively. Cerebral circulatory arrest time was 65 +/- 14 min (32-93 min), and significant oxygen and lactate extraction were noted in the brain. Eleven cases showed no neurologic deficit, but loss of consciousness due to other causes occurred in 3. In conclusion, this method maintained the aerobic metabolism of the brain and protected it during prolonged cerebral circulatory arrest, simplifying the procedure and permitting both median and lateral approaches.