不停跳心内直视手术对心肌保护的研究  

Effect of off-pump open-heart surgery on the myocardial projection

作　　者：邱立成[1] 王奇[1] 石海燕[1] 王立新[1] 薛炎[1] 罗建[1] 

机构地区：[1]武警部队心脏病研究所武警总医院心血管外科,北京100039

出　　处：《武警医学》2007年第1期17-19,共3页Medical Journal of the Chinese People's Armed Police Force

摘　　要：目的对比心脏不停跳与传统的停跳心内直视手术对先天性心脏病患者的影响,为心脏不停跳手术的临床开展提供理论依据。方法同期收治房间隔缺损(ASD)、室间隔缺损(VSD)和肺动脉狭窄(PS)70例。随机分为体外循环(CPB)跳动下直视手术(实验组)和阻断升主动脉根部灌注冷晶体停搏液(对照组)行心内直视手术,每组35例。术前及术后1、2、61、2、244、8 h检测TNF-α、IL-6、IL-8和IL-10、CK、cTnI含量。结果实验组手术时间和体外循环时间较对照组明显缩短,术后多巴胺用量较少。患者血浆IL-6、IL-8、IL-10、TNF-α。含量在相同时点,实验组含量低于对照组(P<0.05)。术后6 h1、2 h,对照组CK、cTnI较实验组显著升高(P<0.01)。结论浅低温CPB心脏跳动下心内直视手术对心肌的保护作用优于停跳组,是安全有效的。Objective To study the effect of off- pump open- heart surgery on the myocardial protection. Methods Seventy patients with atrial septal defect, ventricular septal defect,and pulmonary stenosis were randomly divided into two grouts：the treatment group（ n = 35） was operated on beating heart under extracorporeal circulation （ECC） ,and the control group（ n = 35）on not beating heart. TNF- α, IL- 6, IL-8, IL- 10, CK,and cTnI levels were assayed prcoperation and 1, 2, 6, 12, 24, 48 h postoperation.Results Tho operating time and ECC duration were shortened and the dosage of dopamine was decreased,compared with the control group.IL- 6, IL- 8, IL- 10, TNF- α, CK, and cTnI contents in treatment group were lower than those in control group. Conclusions Off- pump open - heart surgery have better effect on the myocardial projection than the pump open- heart surgery, and it is safe and efficient.

关 键 词：不停跳心内直视手术 心肌保护 心脏手术 

分 类 号：R654.2[医药卫生—外科学]