温血诱停及终末再灌注在冠状动脉搭桥术中的应用  

Usage of warm oxygenated blood induced cardiac arrest and final perfusion in coronary artery bypass grafting

作　　者：郑俊猛[1] 王得坤[1] 姜海明[1] 李斌飞[1] 梁毅[1] 叶红雨[1] 张志刚[1] 舒惠萍[1] 

机构地区：[1]中山市人民医院心胸外科,广东中山528403

出　　处：《宜春学院学报》2002年第2期57-59,共3页Journal of Yichun University

摘　　要：目的 :总结温氧合血诱导停搏及终末再灌注心肌保护在冠状动脉搭桥术中应用的经验 .方法 :2 1例冠心病患者中 85 7%为多支冠状动脉病变 .8例左室射血分数≤ 4 5 % ,其中 3例 <30 % .均在中等低温体外循环下CABG .急症CABG1例 .常规采用左乳内动脉 (LIMA)与左前降支(LAD)搭桥 ,余均选用大隐静脉桥 .人均搭桥 2 8支 .心肌保护方法为主动脉根部温氧合血顺灌诱导停搏及终末再灌注 ,4℃冷晶体停搏液间断灌注维持停搏 .观察心脏自动复跳率及复苏后心律紊乱情况 ,术后恢复情况 .结果 :心脏自动复跳率 90 5 % ,复跳后心律规则、平稳 .术后左室顺应性 ,心功能恢复较好 .术后病人心绞痛完全消失 .结论 :温氧合血诱导停搏及终末再灌注心肌保护效果好 .对心功能不全 。Objective: To retrospectively review the experiment of warm oxygenated blood induced cardiac arrest and final perfusion in coronary artery bypass grafting Method: CABG was performed on 21 patients(13 male, 8 female;age ranged from 46 to 80 years,mean 62 5 years) 85 7% of them had multiple coronary artery disease Left ventricular ejection fraction (EF) were equal to or lower than 45% in totally 8 patients, less than 30% in 3 patients All procedures (21 patients) were performed on hypothermia cardiopulmonary bypass (CPB) , Myocardial protection was carried out by warm oxygenated blood inducing cardiac arrest, intermittent 4℃ cold crystalloid cardioplegia perfusion and warm oxygenated blood final perfusion The average number of grafts were 2 8 and the infernal mammary artery were used in 17 patients Result: It had high rate of spontaneous resuming of heart beat (90 5%) The hearts beat regularly and placidity after resuming There were good recoveries of left ventricnlar compliance and function Conclusion: Warm oxygenated blood inducing cardiac arrest and final perfusion cardioplegia has good clinical results in myocardial protection Warm oxygenated blood inducing cardiac arrest and final perfusion cardioplegia should be used in patients with heart dysfunction risk of CABG

关 键 词：温血诱停 终末再灌注 冠状动脉搭桥术 应用 体外循环 心肌保护 温氧合血停搏液 冠心病 冠状动脉病变 

分 类 号：R654.2[医药卫生—外科学]