摘要目的 观察体外静脉一静脉转流对患者血流动力学、生化和体温的影响.方法 施行原位异体肝移植术8例,术中使用离心泵、血液变温器、部分肝素化方法行体外静脉转流.结果 体外静脉转流时间为:(109±35)min;灌注量300～1 000ml/min,平均动脉压(MaP)维持在60～96mm Hg(1mm Hg=0.133 kPa),中心静脉压(CVP)4～14 cm H2O,鼻咽温(35.9±0.8)℃,激活凝血时间(ACT)为:(238±45)S,血气及生化结果基本正常.停止转流后血流动力学稳定,未出现心律紊乱.结论 采用离心泵,血液变温器和部分肝素化的静脉转流方法可减少患者无肝期血流动力学、生化等方面的影响,临床效果好.

abstractsObjective To observe the effects of extracorporeal veno-venous bypass on hemodynamics,biochemistry,body temperature during liver transplantation.Methods Venovenous bypass with Sarns Delphin Ⅱ Centifugal pump,Sarns heat exchanger and partial heparinization was used in 8 cases undergoing allogenic orthotopic liver transplantation.Results The average time of extracorporeal venous bypass was (109±35)min.Perfusion flow rate was 300 to 1 000 ml/min.Mean arterial pressure(MAP)and CVP were maintained at 60 to 96 mm Hg and 4 to 14 cm H2O,respectively.The average nasopharyngeal temperature and ACT were maintained at(35.9±0.8)℃and(238±45)s.The results of blood gas analysis and biochemical test were normal.There was no cardiac arrhythmia.Conclusions The use of the centrifugal pump,heat exchanger and partial heparinization in extracorporeal veno-venous bypass may reduce the effects on the patients' hemodynamics and biochemistry.The technique can achieve good results in clinical practice.