康斯特保护液对未成熟心肌保护效果的临床观察  

The Observation of Bretschneider's Cardioplegia Solution on Infants' Immature Myocardial Protection

作　　者：李桂芬[1] 王仕刚[1] 胡强[1] 刘迎龙[1] 龙村[1] 赵红[1] 

机构地区：[1]中国医学科学院阜外心血管病医院体外循环科,北京100037

出　　处：《中国体外循环杂志》2006年第1期9-11,共3页Chinese Journal of Extracorporeal Circulation

摘　　要：目的探讨康斯特保护液(HTK液)在婴幼儿心内直视手术中心肌的保护作用。方法36例择期行心内直视手术的婴幼儿随机分为两组。实验组灌注HTK液,对照组灌注ST.Thom as液。两组分别于阻断升主动脉前,开放升主动脉后3 m in由冠状静脉窦取血,行肌酸激酶同工酶(CK-MB),乳酸脱氢酶(LDH),心肌肌钙蛋白(cT-nI)检测。开放升主动脉前自右室流出道取心肌组织0.3 cm×0.3 cm两块,行超微结构观察。结果血清CK-MB、LDH和cTnI浓度变化:开放升主动脉后较缺血前两组均明显升高。心肌结构改变:对照组可见心肌细胞水肿,片状肌浆凝聚,心肌纤维呈波纹状改变,线粒体轻度肿胀,部分嵴断裂,空泡形成。实验组超微结构改变较对照组轻。结论HTK心脏停搏液对未成熟心肌有良好的保护作用。可减轻心肌细胞及间质水肿,肌原纤维结构破坏轻,线粒体损伤轻。单次灌注避免多次灌注所致的心肌细胞水肿和冠脉血管内皮的损伤。OBJECTIVE Investigate the myocardial protection of Bretschneider during heart surgery of infant. METHODS 36 infants of heart surgery were divided into two groups. One group perfused HTK solution, the other group perfused ST. Thomas solution. Ge the blood sample from coronary sinus before clamp the aorta and 3rains after declamping the aorta. The CK - MB, LDH and cTnI were measured. Two pieces of cardiac muscle about 0.3cm × 0.3cm were taken from right ventricular before declamping aorta , then observed by laser Confocal Scanning Microscope. RESULTS The concentration of CK - MB, LDH and cTnI were all increased significantly after declamping the aorta in two groups. The supermicro -changes were less in HTK group than in ST. Thomas group. CONCLUSION HTK solution could protect the immature cardiac muscle.

关 键 词：婴幼儿 心肌保护 心脏停博液 体外循环 

分 类 号：R726.5[医药卫生—儿科]