浅低温体外循环心脏跳动中二尖瓣替换术的临床研究  

Extracoporeal circulation under low temperature for mitral valve replacement in beating heart

作　　者：王功朝[1] 陈忠堂[2] 

机构地区：[1]山东大学护理学院临床胸心外科,济南250012 [2]山东大学临床医学院济南市中心医院心外科

出　　处：《山西医科大学学报》2005年第1期115-117,共3页Journal of Shanxi Medical University

基　　金：山东省济南市科委立项课题 ( 2 0 0 3 -0 3 )

摘　　要：目的　评价浅低温体外循环 (CPB)心脏跳动中二尖瓣替换术的疗效及其对心肌的保护作用。方法　将 30例二尖瓣狭窄并关闭不全患者随机分为两组各 15例 ,非停跳组在浅低温 (31～ 33℃ )CPB心脏跳动中行二尖瓣置换术 ,停跳组采用传统心脏停跳法行瓣膜置换术。结果　非停跳组术后病情平稳 ,多巴胺用量 0～ 5 μg·kg-1·min-1,少于停跳组 3～ 10 μg·kg-1·min-1,P <0 .0 1;无低心排综合征、严重心律失常及气栓栓塞等严重并发症。停跳组术中并发低心排综合征 1例 ,频发室性早搏 2例。术中二尖瓣置换后及术后 4h ,停跳组血清心肌酶含量较非停跳组显著增加 (P <0 .0 1)。结论　浅低温CPB心脏跳动中二尖瓣置换术是一种安全、有效。Objective To evaluate the curative effect and myocardial protective effect of extracoporeal circulation with low temperature (31 to 35 ℃) on mitral valve replacement in beating heart. Methods Thirty patients with mitral valve stenosis and insufficiency were divided into control group (n=15)and test group (n=15). In test group, mitral valve replacement was performed in beating heart under extracoporeal circulation with low temperature without application of cardioplegia and without aortic block. In control group, mitral valve replacement was performed with traditional method. Results After operation, all test group patients had a good recovery and did not develop any serious arrythmia or low-output syndrome or gas embolism. Dopamine dose was lower in test group than in control group (P<0.01).There was significant difference between blood CK and LDH levels after mitral valve replacement. Conclusion Extracoporeal circulation with low temperature for heart valve replacement in beating heart is a simple, safe and has myocardia protection, which is closed to physiological state.

关 键 词：体外循环 心脏外科手术 二尖瓣替换 

分 类 号：R654.2[医药卫生—外科学]