仲山医第一附属医院肯定有这个技术实力,无需他们飞过去了。等会儿要在手术中负责摘取捐献者供心的医生是叶传广医生了。“你们那边的医生对我们这边有什么要求吗?”叶传广问。谢婉莹边讲电话的时候,手里拔下圆珠笔。见状,魏同学帮她掏出笔记本方便她在笔记本上书写。谢婉莹写明自己要与对方协调的事项让程老师过目。程昱辰医生边看,边点头。获得老师的同意后,谢婉莹说道:“首先,供心运送的距离比较长路上时间长,有些准备工作需要叶老师您们费心配合。”“不用客气的。”叶传广坦诚说,“你们不打电话过来,我们本也想问问你们是什么打算。是不是需要我们从主动脉根给供心再灌入心脏停搏液保存?”“是。”厉害的老师,无需多说一句几乎秒懂的。“但是你们要清楚,心脏冷缺血时间最好是不要超过五六个小时。”叶传广唠唠叨叨提醒提醒,不要以为有了多做点准备步骤可以万事大吉了,最多拖长一点时间而已。冷缺血可以说是器官移植技术中的一個专有名词了。说冷缺血前先说另一个差不多的技术名词:热缺血。器官从捐献者心脏停跳后摘下来进行冷保存之前的这个操作时间段叫做热缺血。冷缺血相对应是器官离开供体到移植进入受体的时间段,这里最主要指的是路上运输时间。每种器官的热缺血和冷缺血时间均有上限的。比如说,心脏热缺血和冷缺血上限最短,分别为十分钟和八小时。这里的十分钟和八小时是超级上限,相当于大冒险。没人可以轻易冒得起这个险的。所以有叶医生说的冷缺血时间最好别超过五六个小时。他们医院摘取供心的热缺血时间会控制到五分钟内。灌入心脏停搏液是怎么回事呢?这里再说到,器官从供体摘下来时细胞没死在继续进行新陈代谢的。由于中断了血流没有血液滋养,拿出来的器官必然发生自我消耗的代谢损伤。可以想见热缺血这个时间段对供体器官损伤最大,需要熟练的专业医生来做这个事尽可能缩短手术时间。.xqqxδ捌冷缺血阶段又该如何对供心进行保护。从医学技术上来讲,要么是最理想的状态,用机械模拟正常人体给供心持续灌注,这样损伤最小。问题是长途运输根本办不到这点,只能退而求次了,用其它方法降低供心的新陈代谢速度减少损伤,所以一般器官保存液里必然有低温和其它成分用来抑制器官细胞代谢。心脏的能量消耗,最主要是心脏收缩舒张的运动以及心肌细胞代谢组成。前者占了总消耗的百分之九十。用心脏停搏液可以让心脏机械活动停止,加上低温降低心肌细胞代谢,两者结合等于一加一,降低损耗的效果增倍。保护心肌是一方面。另一方面由于心脏不像肝脏,结构特殊,供心和受体需要多处端口吻合。
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