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[对一名具有镰状细胞性状患者进行体外循环心脏手术]

[Cardiac surgery using cardiopulmonary bypass in a patient with sickle-cell trait].

作者信息

Ohashi Y, Akamatsu T, Hirata T, Uchida O, Kuro M

机构信息

Department of Anesthesiology, National Cardiovascular Center, Suita.

出版信息

Masui. 1996 Oct;45(10):1269-71.

PMID:8937027
Abstract

The sickle-cell gene is most concentrated in West Central Africa, the northeast corner of Saudi Arabia and East Central India. Sickle cell trait is the heterozygous condition for Hb S gene. Thirty to fifty per cent of their hemoglobin is Hb S and the remainder is Hb A. The sickle-cell crisis is induced by hypoxia, hypercarbia, acidosis, low flow condition, and hypothermia, which leads to vasoocclusion. A 39-year-old black man from Burkina Faso located in West Africa with left ventricular rupture was admitted for operation using cardiopulmonary bypass (CPB). He had been diagnosed as sickle-cell trait. The Hb S concentration was 36.2 per cent before operation with hemoglobin electrophoresis. During CPB, the minimum blood temperature was 31 degrees C and an aortic cross-clamp was not done. Total CPB time was 1 hour 31 minutes. Use of vasodilator and hyperventilation was effective. No neurological sequelae were observed.

摘要

镰状细胞基因在非洲中西部、沙特阿拉伯东北角和印度中东部最为集中。镰状细胞性状是Hb S基因的杂合状态。他们30%至50%的血红蛋白是Hb S,其余是Hb A。镰状细胞危象由缺氧、高碳酸血症、酸中毒、低血流状态和体温过低诱发,进而导致血管阻塞。一名来自西非布基纳法索的39岁黑人男性因左心室破裂入院接受体外循环(CPB)手术。他被诊断为镰状细胞性状。术前血红蛋白电泳显示Hb S浓度为36.2%。在CPB期间,最低血温为31摄氏度,未进行主动脉交叉钳夹。CPB总时间为1小时31分钟。使用血管扩张剂和过度通气有效。未观察到神经后遗症。

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