CAJ | 학술논문

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0.5～3.5L/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）cmH2O，鼻咽温为（36.8±0.47）℃，激活全血凝固时间为280～320s，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。
목적평개체외정맥-정맥전류기술대원위간이식술중무간기혈류동역학、생화、체온화신공능적영향。방법 28례원위간이식술중사용Jostra RotaFlow리심빙、열교환기、변연간소화진행개방식정맥-정맥전류。결과체외정맥-정맥전류시간（136.7±60.4）min，관주류량0.5～3.5L/min，동맥압유지재（82.3±3.3）mm Hg，중심정맥압유지재（8.12±4.05）cmH2O，비인온위（36.8±0.47）℃，격활전혈응고시간위280～320s，혈액기체급생화지표기본정상，정지전류후혈류동역학은정；10례적기항급뇨소담균유하강。결론채용리심빙、열교환기、변연간소화적체외정맥-정맥전류기술가위간이식적순리진행제공량호지지。
Objectives　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 0.5～3.5L/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 280～320s 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.