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目的分析Switch术(大动脉调转术)治疗完全性大动脉转位的体外循环管理技术关键。方法应用Switch术治疗完全性大动脉转位7例。采用深低温停循环结合深低温低流量(DHCA+DHLF)技术,所有患者采用PH稳态结合α稳态的血气管理方法,术中均采用平衡超滤(ZUF)结合传统超滤(CUF)方法,术毕行改良超滤法(MUF)。结果本组手术死亡1例,心脏自动复跳率100%。结论体外循环中采用综合性管理措施是取得Switch手术成功的保障。
Objective To analyze the key point of cardiopulmonary bypass management of Switch (aortic transfer surgery) for the treatment of complete aortic transposition. Methods Seven cases of complete aortic transposition were treated with Switch. All patients underwent PH steady-state and alpha-steady state blood gas management using deep hypothermic circulatory arrest combined with deep hypothermic low-flow (DHCA + DHLF) technique. All patients underwent ultrafiltration (ZUF) combined with traditional ultrafiltration (CUF) , Surgery line improved ultrafiltration (MUF). Results The group died of surgery in 1 case, the heart automatically rebound rate of 100%. Conclusion The use of integrated management measures during cardiopulmonary bypass is the guarantee of successful Switch operation.