缺血预适应对体外循环血流动力学影响的临床研究  

Effects of ischemic preconditioning on hemodynamic during cardiopulmonary bypass

作　　者：邓云坤[1] 饶永霞[1] 熊顺祥[1] 冯亚萍[1] 令狐洪[1] 李正伦[2] 杨世虞[2] 舒义竹[2] 张大国[2] 阎兴治[2] 刘秀伦[2] 

机构地区：[1]贵州省人民医院麻醉科,贵阳550002 [2]贵州省人民医院心外科,贵阳550002

出　　处：《贵州医药》2001年第1期11-13,共3页Guizhou Medical Journal

基　　金：&&

摘　　要：目的比较冷停搏液与缺血预适应 (IPC)加冷停搏液联合应用对先天必心脏病心内直视手术后血流动力学的影响。方法先天性心脏病病人 2 0例 ,随机分为缺血预适应组 (IPC ,n =10 )和对照组 (n =10 )。IPC组在阻断升主动脉前实施缺血预适应 (即 3分钟缺血 5分钟再灌注 ) ,阻断升主动脉 ,灌注 (4℃ )StThomas’停搏液 ,心脏完全停跳后开始心内手术 ;对照组则不进行缺血预适应方案。两组均于并循前、开放升主动脉心脏复跳后 30min、6 0min时经Swan -Ganz漂浮导管测定各项血流动力学指标 ,并观察心肌功能恢复情况、动脉血气及电解质变化。结果CPB后IPC组血流动力学指标恢复快 (P <0 .0 5 ) ,心肌收缩有力 ,血压维持良好 ,需辅用多巴胺等强心药维持血压的病例明显少于对照组 (P <0 .0 5 ) ;两组动脉血气无明显变化 (P <0 .0 5 )。结论缺血预适应应加冷停搏液联合应用能促进体外循环心内直视手术后血流动力学的恢复。Objective To evaluate the effects of ischemic preconditioning (IPC) with cold cardioplegia perfusion on hemodynamci during cardiopulmonary hypass (CPB). Methods Twenty congenital heart disease patients were randomly divided into two groups. Control group ( n =10) received intermittent cold crystalloid cardioplegia perfusion. IPC group ( n =10) receive IPC by clamping aorta 3 minutes and then declamping 5 minutes before cold cardioplegia perfusion.Hemodynamic parameters,blood gas and electrolyte were recorded before CPB,30 min and 60min arter declamping aorta by Swan-Ganz catheter.Results In IPC group the recovering of hemodynamic parameters was sooner after CPB ( P <0.05).The blood pressures were excellent maintained and the proportion of using positive inotropic drugs such as dopamine were lower in IPC group.There's no significant change in blood gas analysis before and after CPB.Conclusion The combination of IPC and cold cardioplegia perfusion could improve hemodynamic during CPB.

关 键 词：缺血预适应 冷心停搏液 血流动力学 体外循环 心内直视手术 

分 类 号：R654.2[医药卫生—外科学]