摘要目的评价体外静脉-静脉转流技术对原位肝移植术中无肝期血流动力学、生化、体温和肾功能的影响。方法 28例原位肝移植术中使用Jostra RotaFlow离心泵、热交换器、边缘肝素化进行开放式静脉-静脉转流。结果体外静脉-静脉转流时间(136.7±60.4)min,灌注流量0.5~3.5L/min,动脉压维持在(82.3±3.3)mm Hg,中心静脉压维持在(8.12±4.05)cmH2O,鼻咽温为(36.8±0.47)℃,激活全血凝固时间为280~320s,血液气体及生化指标基本正常,停止转流后血流动力学稳定;10例的肌酐及尿素氮均有下降。结论采用离心泵、热交换器、边缘肝素化的体外静脉-静脉转流技术可为肝移植的顺利进行提供良好支持。
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abstractsObjectives Evaluate the effect of venous-venous bypass on hemodynamics, biochemistry and body temperature during orthotopic liver transplantation. Methods Venous-venous bypass with Jostra RotaFlow centifugal pump, heat exchanger were used and partial heparinization performed in 28 cases undergoing allogenic orthotopic liver transplantation. Results The average duration of venous-venous bypass was 87~398 min (136.7min±60.4!min), perfusion flow rate was 0.5~3.5L/min, mean arterial pressure and CVP maintained at (82.3±3.3)!mmHg and (8.12±4.05)cm!H2O respectively, the average nasopharyngeal temperature and ACT maintained at (36.8±0.47)℃ and 280~320s respectively. The results of gas analysis and biochemical test were normal. Conclusions The use of the centrifugal pump and heat exchanger with partial heparinization in venous-venous bypass can provide a good support to orthotopic liver transplantation.
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