逆行左室插管转流和不同转流率影响辅助效应的实验观察  

EXPERIMENTAL STUDY ON THE EFFECTS OF DIFFERENT BYPASS FLOW RATES DURING RETROGRADE VENTRICULAR ASSIST FOR ACUTE MYOCARDIAL ISCHEMIA

作　　者：张怀军[1] 朱晓东[1] 李永利[1] 唐承君[1] 王志民[1] 袁伟民 宫路佳[1] 孟亮[1] 董以千 杨舒亚 

机构地区：[1]中国医学科学院,中国协和医科大学心血管病研究所,中国协和医科大学阜外心血管病医院

出　　处：《中国循环杂志》1995年第3期160-162,共3页Chinese Circulation Journal

摘　　要：建立经动脉逆行左室插管转流模型，观察了５种不同转流率（ＢＦＲ）对犬正常及急性缺血心脏的辅助效应。结果表明：各ＢＦＲ均能增加全心输出量（ＴＣＯ），冠状窦引流量（ＣＳＢＦ）及降低心肌缺血后左房压和左室舒张末压（ＬＶＥＤＰ）。以７５％ＢＦＲ辅助效果最为明显。８５％以上ＢＦＲ时，ＴＣＯ，ＣＳＢＦ并无进一步增加，且室间隔增厚率，运动幅度及右室面积变化率均有明显下降，右室舒张末压（ＲＶＥＤＰ）增大。提示大流量转流对改善心功能并非必需，且对缺血心脏的右心功能有潜在的损害效应。The effects of five different bypass flow rates(BFR) (25%and 50%, 75% , 85% and100% , BFR= bypass flow /total cardiac output×100% )on normal(n=5) and acute cardiac ischemic (n= 6 ,by ligation of the LAD coronary artery) dogs through femoral artery-left ventricular reperfusion were studied. At each BFR . there were increase in both TCO(total cardiac output) and CSBF(coronary sinus blood flow) and decrease in both mLAP and LVEDP in the ischemia heart, but 75% BFR caused the most significant change. Over 85% BFR, no further increase in both TCO and CSBF was found but with significant reduction in interventricular septum wall thickness and interventricular septum motion extent, as well as in right ventricular fractional change in cross-section area but RVEDP increased. The results indicated that excessive left ventricular bypass flow is not necessary for the improvement of cardiac function. A flow rate over 85% is potentially disadvantageous to RV function, particularly in the presence of myocardial ischemia.

关 键 词：转流率 左心辅助装置 心力衰竭 

分 类 号：R541.61[医药卫生—心血管疾病]