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编号:10793425
冷凝集阳性患者的体外循环处理
http://www.100md.com 《中国体外循环杂志》 2005年第2期
冷凝集素,,冷凝集素;,体外循环;温度,1病例资料,2方法和结果,3讨论,参考文献:
     摘要:目的 探讨体外循环(CPB)术中发生冷凝集试验阳性的处理经验。方法 采用最适宜的温度(鼻咽温31.5℃~32.5℃,肛温34℃~35℃),常温高钾停跳液,CPB大剂量抑肽酶和皮质激素的应用及激活全血凝血时间(ACT)的严格监测等等。结果 术中阻断主动脉65min,心脏自动复跳,术后无中枢神经系统并发症及血红蛋白尿。结论 对CPB术中发生冷凝集试验阳性的病人采取综合性的防救措施可以有效的防止红细胞凝集、溶血等不良反应,确保手术安全。

    关键词:冷凝集素; 体外循环;温度

    Management of Positive of Cold Agglutination Test Patient During CPB

    REN Xin-ying, LI Yi-mei,FU Chuen-ling

    (Department of Anesthesiology First Affiliated Hospital of Xinjiang

    Medical University,Xinjiang Urumqi,830000,China)

    Abstract: OBJECTIVE To report the experincein treating a case of positive cold agglutination test during cardiopulmonary bypass (CPB). METHODS Adopting the most appropriate temperature (nasopharyngeal temperature 31.5℃~32.5℃, anal temperature 34℃~35℃). Hyperkalemia cardioplegia solution at room temperature, large doses of aprotinin and cortin, during CPB and moniting closely for ACT.RESULTS Aorta was clamped for 65 min. The heart beat recoverd spontmandly. There was no CNS complication or haematuria after the operation CONCLUSION Adopting maltiple measures in cold agglutination test positive patientsduring CPB coued effectively prevent agglutination of red blood and haemolysis, so warrant operative success. ......

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