温血心麻痹液心肌保护在法乐四联症矫正术中的应用  

Myocardium protection using warm blood cardioplegiain corrective operation of tetralogy fallot

作　　者：陈若为[1] 汪曾伟[1] 徐凤翔[1] 张静[1] 

机构地区：[1]中国人民解放军沈阳军区总医院心外科,空军郑州医院

出　　处：《中华外科杂志》1994年第8期499-501,共3页Chinese Journal of Surgery

摘　　要：作者选择临床资料相近的法乐四联症心内矫正术的患儿，根据术中使用心麻痹液的不同分为四组。Ｓｔ．Ｔｈｏｍａｓ液组（ＣＣ组）２４例，冷血心麻痹液组（ＣＢＣ组）２１例，终末温血心麻痹液组（ＴＷＢＣ组）１２例，持续温血心麻痹液组（ＣｗＢＣ组）１２例。通过术后左心室测压，术后ＣＫ－Ｍｂ测定，显示ＴＷＢＣ组、ＣＷＢＣ组心肌保护效果优于ＣＣ组、ＣＢＣ组（Ｐ＜０．０５）。心肌ＡＴＰ含量测定ＴＷＢＣ组、ＣＷＢＣ组分别为１７．１４±８．４５μｍｏｌ／ｇ和１８．２４±５．６５μｍｏｌ／ｇ，ＣＢＣ组为２．４８±１．２９μｍｏｌ／ｇ（Ｐ＜０．０１）。ＣＰ含量分别为８．７６±２．１４μｍｏｌ／ｇ、７．６２±１．０８μｍｏｌ／ｇ和５．５±０．３３μｍｏｌ／ｇ（Ｐ＜０．０５）。ＣＣ组有３７％的病例需要正性肌力药物辅助心功，ＣＢＣ组为１９％，ＴＷＢＣ组、ＣＷＢＣ组均为１６％。本文结果表明ＷＢＣ液具有较好的心肌保护效果。Abstract In this paper,the children,who had undergonethe operation with the approach semilar to that of Te-tralogy Fallot,were selected and devided into 4groups,according to different kinds of cardioplegiawere infused during corrective operation. St.Thomasgroup(CC group)24 cases,cold blood cardioplegiagroup(CBC group)21 cases,terminal warm bloodcardioplegia group(TWBC group)12 cases,and con-tinuous warm blood cardioplegia group(CWBC group)12 cases. Through the measurement of left ventricularcontraction pressure and CK-Mb release in the postop-erative period, the effect of myocardial preservationwas better in TWBC and CWBc groups than in CC andCBC groups(P< 0.05),ATP volume of myocardiumin TWBC and CWBC groups were higher(1 7.1and18.2μmol/g)than that in CBC group(2.48μmol/g)(p<0.01)CP values were respectively 8.74μmol/g,7. 63μmol/g and 5. 5μmol/g(P<0.05).9 cases(37%)in CC group needed inotropic drug to assist circulatlonpostoperation,4 cases(16%)in CBC group,2 cases(12%)in both TWBC and CWBC group.The resultsdemonstrated that WBC had a better myocardial pro-tection effect.

关 键 词：心麻痹液 心肌保护 法乐四联症 

分 类 号：R654.2[医药卫生—外科学]