心肌保护液经泵连续灌注的临床应用  

CLINICAL APPLICATION OF CONTINUOUS PERFUSION WITH MYOCARDIUM PROTECTING LIQUID BY PUMP

作　　者：卢玉敏[1] 孙克[1] 孙晓阳[1] 

机构地区：[1]齐齐哈尔医学院教学医院

出　　处：《齐齐哈尔医学院学报》1994年第3期110-113,共4页Journal of Qiqihar Medical University

摘　　要：通过泵灌方式,将心肌保护液经主动脉根部顺灌和经冠状静脉窦逆灌,即对心肌阻断在5O～266分钟的20例病人采用氧含血+晶体停搏液作重复灌注以保护心肌,临床效果良好.灌注装置连接与使用方便,可保证灌注的温度、压力和数量的准确.氧合后的动脉血通过微栓滤器可防止微栓进入冠状血管,且为心肌提供代谢基质,补偿两次灌注期间所产生的氧债,缓冲无氧代谢酸性产物的产生.胶体渗透压增加防止心肌细胞水肿.经冠状静脉窦口连续逆灌复温后的血液,可为心肌提供有氧代谢,使心肌复温均恒,促使心脏在主动脉开放后自动复跳.通过对10例病人的心电图和心肌温度的观察,心脏停跳确切,心肌温度保持在10～20℃,灌注效果满意.This article mainly inducted the clinical application of the orthodromic perfusion through the root of aoita and the antidromic peifusion through coronary artory sinus with the myocardium protecting liquid. The clinical effects was good.We applied the oxidized blood plus crystal pulsation-stopping liquid for repeated perfuse to protect cardiac muscle for the twenty patients with cardiac musclestopping time between 50-266 minutes. This perfusion instrument connects simply, it can guaran tee the temperature of the perfusion liquid, control the pressure of perfusion, and the perfusion quantity is precise. We could apply the oxidized arterial blood through microembo lus filter instrument for perfusion, it could prevent the microe-mbolus inflowing the coronary vessel, and supply the metabolic susbstance, compense the oxygen debt between the two perfusions and produce the an-aerobic product a cushing effect. The increase of the colloid osmotie pessure can prevent the cardiac cells from edema. The rewarming blood of continuous antidromic perfusion could supply the oxygenic metabolism for the myocardium, make the myocardium rewarming equalize, promote the heart anto repump after the openning of aorta. Through the obervation of ECG and the temperature of the myoca rdium of 10 patients, we found the heart stop precisely. The temperature of myocardium maintains between 10-20℃,the perfusion effect was satisfied.

关 键 词：心肌保护 临床应用 灌注 氧合 主动脉 复温 心电图 无氧代谢 

分 类 号：R654[医药卫生—外科学] R541[医药卫生—临床医学]