前纵隔肿块切除术和上腔静脉置换术中的颈内静脉-股静脉转流术

IF 0.8 Q3 ANESTHESIOLOGY Anaesthesia reports Pub Date : 2024-09-17 DOI:10.1002/anr3.12326
L. Su, J. Dai
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引用次数: 0

摘要

切除前纵隔肿块并人工置换上腔静脉的手术会严重破坏循环系统。在这个病例中,夹闭上腔静脉后,建立了一条将血液从颈内静脉引流到股静脉的通道。通常经上腔静脉回流到右心房的血液现在经下腔静脉回流。在夹闭上腔静脉时,平均动脉压至少要比中心静脉压高出 50 毫米汞柱,以避免脑灌注不足。上述策略的综合使用旨在提供令人满意的手术条件和脑保护。
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Internal jugular vein-femoral vein diversion during anterior mediastinal mass resection and superior vena cava replacement

Surgery which involves anterior mediastinal mass resection with artificial replacement of the superior vena cava results in significant disruption to the circulatory system. In this case, a pathway was established to divert blood from the internal jugular to the femoral vein after clamping of the superior vena cava. Blood which would ordinarily return to the right atrium via the superior vena cava was now being returned via the inferior vena cava. The mean arterial pressure was maintained at least 50 mmHg higher than the central venous pressure during clamping of the superior vena cava to avoid cerebral hypoperfusion. The combined use of the above strategies aimed to provide satisfactory surgical conditions and cerebral protection.

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