温血停搏液持续逆行灌注对心肌保护作用  

Myocardium Protection with Warm Blood Cardioplegia Under Continuous Retrograde Perfusion

作　　者：李晓霞 姜敏炎 唐岳云 吴伟敏 吕亚军 

机构地区：[1]江苏省武进市人民医院,江苏武进213002

出　　处：《中国体外循环杂志》2005年第1期25-27,共3页Chinese Journal of Extracorporeal Circulation

摘　　要：目的　研究温血停搏液经冠状静脉窦持续灌注对心肌保护作用。方法　60例心脏瓣膜病患者,随机分成两组:持续灌注组(实验组n=30)和间断灌注组(对照组n=30)。术中测定心肌酶及取心肌组织电镜观察超微结构。结果　对照组与实验组相比,心肌酶峰值提前,且持续时间较长。心肌超微结构显示:对照组心肌细胞线粒体出现普遍空泡化,部分嵴溶解。结论　温血心肌停搏液持续逆灌对心肌保护作用优于间断灌注组,适合重症心脏病心瓣膜置换术患者。OBJECTIVE To evaluate the myocardial protection using continuous retrograde conorary sinus perfusion with warm blood cardioplegia(WBC).METHODS Sixty patients with valvular disease were randomly divided into two groups:a study group who received continuous retrograde warm blood hyperkalemia cardioplegia, and a control group who received cold blood hypokalemic cardioplegia,30 patients in each group. Cardiac enzymes were taken during the operation and cardiac tissue biopsies were incised for observation of myocardial ultrastructure under electrical microscope.RESULTS Compared with the study group, the peak of the cardiac enzymes appeared earlier and lasted longer in control group. The cardiac ultrastucture study showed that the myofibris and mitochondria damages were serever in the control group. CONCLUSION The myocardial protective effect under contious retrograde warm blood cardioplegia perfusion was better than that under intermittent blood cardioplegia perfusion. The method is suitable for critical patients undergoing valev replacement surgery.

关 键 词：心肌保护作用 停搏液 对照组 温血 逆行灌注 持续灌注 患者 心肌酶 心脏瓣膜病 冠状静脉窦 

分 类 号：R654.2[医药卫生—外科学]