1：1血晶心停跳液不同流量连灌对心肌的保护作用  

Study of enzyme function on 1： 1 blood crystalloid cardioplegia at different flow continuous perfusion

作　　者：刘宁[1] 

机构地区：[1]河南省商丘市第一人民医院心血管外科,商丘476100

出　　处：《中原医刊》2007年第16期4-5,共2页Central Plains Medical Journal

摘　　要：目的探讨1∶1血晶心停跳液不同流量连灌对心肌的保护作用。方法选择80例择期手术患者分别用1∶1血晶心停跳液微流量连灌[A组0.5 ml/（kg.min）],高流量连灌[B组2.0 ml/（kg.min）]灌注结果进行分析。选择主动脉阻断时间大于60 min者各40例,分别记录术前、术后6、12、24、48、72 h内肌酸磷酸激酶（CPK）、心肌型肌酸激酶同工酶（CK-MB）、乳酸脱氢酶（LDH）、乳酸脱氢酶同工酶（LD-1）的变化,进行组内和组间对比研究。结果术后72 h内,两组CPK、CK-MB、LDH、LD-1均有不同程度升高,峰值多在术后12-24 h,组内比较显示与主动脉阻断前差异有统计学意义（P〈0.05）,大部分在72 h降至正常。组间比较结果显示：两组之间差异无统计学意义（P〉0.05）,临床结果表明,两组术后需循环和呼吸辅助时间短,心功能恢复迅速、稳定。结论微流量1∶1血晶心停跳液连续灌注亦能保持心肌能量储备,术后心功能恢复迅速。Objective To investigate the effects of different flow volume of continuous blood cardioplegia on open heart surgery. Methods Retrospective randomized study was performed on 80 patients undergoing valve replacement and congenital heart disease with myocardial protection by minimum flow perfusion [ 0.5 m]/（ kg · rain ） ], group A, n = 40, high - folw perfusion [ 2.0 m]/ （kg · min） ] ,group B, n =40,cardioplegia. Preoperative and surgical characteristics of the two groups were similar. Results Dur- ing the first 72 postoperative hours the value of CPK, CK - MB, LDH and LD - 1 in two groups were increased to different degree, serum enzymes level increased significantly between 12 -24 hours later operation（ P 〈 0.05 ） and return to normal at 72 postopera- tive hours in two groups. But between two groups there is no significant difference（ P 〉 0.05）. Conclusion Minimum - flow con- tinuous perfusion of 1： 1 blood crystalloid cardioplegia appeared to be superior in safety, decrease of myocardial enzymes integrity.

关 键 词：1∶1血晶心停跳液 高流量 微流量 心肌酶谱 

分 类 号：R54[医药卫生—心血管疾病] R6[医药卫生—内科学]