温血诱导心停跳及终末温血灌注技术对婴幼儿心肌保护作用的临床研究  

Clinical study of the technique of warm induction and reperfusion on protection of young infants' myocardium

作　　者：苏肇伉[1] 万里飞[1] 曹鼎方[1] 陈恩[1] 祝忠群[1] 陈惠文[1] 

机构地区：[1]上海第二医科大学新华医院小儿心胸外科

出　　处：《上海医学》1999年第7期396-398,共3页Shanghai Medical Journal

基　　金：国家自然科学基金

摘　　要：目的探讨温血诱导心停跳及终末温血灌注技术对婴幼儿心肌的保护作用。方法将３岁以下先天性心脏病儿４０例，随机分成温血诱导心停跳及终末温血灌注组（温血组）和冷晶体液停跳组（冷晶体液组）；两组主动脉阻断时间差异无显著性。体外循环前、后分别测定冠状静脉血丙二醛（ＭＤＡ）、超氧化物歧化酶（ＳＯＤ）、一氧化氮（ＮＯ）及内皮素（ＥＴ）含量；选取两组中法洛四联症（ＴＯＦ）患儿缺血后右心室心肌作超微结构对比研究。结果冷晶体液组ＭＤＡ（５．５±２．３）ｍｍｏｌ／Ｌ和ＥＴ（１６．４±６．３）ｎｇ／Ｌ升高值均高于温血组，分别为（１．１±０．５）ｍｍｏｌ／Ｌ及（６．８±２．８）ｎｇ／Ｌ（Ｐ＜０．０５），而ＳＯＤ升高值与ＮＯ下降值两组差异无显著性（Ｐ＞０．０５）。电镜观察缺血后超微结构，温血组优于冷晶体液组。结论温血诱导心停跳及终末温血灌注技术对婴幼儿心肌保护作用有利。Objective To study the protective effect of warm induction and reperfusion on young infants' myocardium. Methods Fourty children with congenital heart disease(aged<3 years old) were randomly divided into two groups: group (warm induction and reperfusion, n=20); group (cold crystalloid, n=20). There were no difference on the aortic crossclamp time in the two groups, blood samples were taken from coronary sinus in prebypass and postbypass to measure MDA, SOD, NO and ET. Postischemic ultrastructure of TOF was observed in two groups. Results MDA (5.52.3) mmol/L,(1.10.5) mmol/L and ET(16.46.3) ng/L, (6.82.8) ng/L released in group were higher than those in group (P<0.05), but there were no significantly differences in SOD (26.09.2) mU/L, (27.310.0) mU/L, NO(19.99.7)mol/L,(18.49.4) mol/L released (P>0.05). Myocardial ultrastructure appeared better preserved in group . Conclusion The technique of warm induction and reperfusion has a good effect on openheart surgery in young infants.

关 键 词：婴幼儿 心肌保护 温血诱导 终末再灌注 

分 类 号：R726.542[医药卫生—儿科]