不同剂量心脏停跳液对室间隔缺损患儿心肌保护效果的临床观察  

Myocardial protective effects of different dose of cold crystalloid hyperkalemic cardioplegia in infants with VSD

作　　者：邓丽[1] 孟维鑫[1] 吴丹[1] 刘宏宇[1] 

机构地区：[1]哈尔滨医科大学附属第一医院心血管外科,黑龙江哈尔滨150001

出　　处：《哈尔滨医科大学学报》2014年第5期409-412,共4页Journal of Harbin Medical University

基　　金：黑龙江省卫生厅科研课题(2011-002)

摘　　要：目的对比研究不同剂量心脏停跳液在室间隔缺损患儿中的心肌保护效果。方法选取45例室间隔缺损患儿,随机分为不同剂量组:1/3剂量组(5 mL/kg)、1/2剂量组(7.5 mL/kg)、全剂量组(15 mL/kg),每组各15例。观察3组患儿的心跳复苏情况、心肌阻断时间、体外循环(CPB)时间、心肌酶学变化、血管活性药物应用及ICU停留时间。结果 3组患儿均顺利复跳、停机,全部存活出院。3组病例心肌阻断时间、体外循环时间、心肌酶学、血管活性药物应用及ICU停留时间无统计学差异(P>0.05)。结论在室间隔缺损的患儿中应用不同剂量的灌注方案是安全可行的。Objective To comparatively study the myocardial protective effects of different dose of cold crystalloid hyperkalemic cardioplegia in infants with ventricular septal defect （ VSD） undergoing open heart surgery.Methods Forty-five infant patients （ weight≤10 kg） with VSD were randomly divided into three groups （15 cases of each group）：1/3 dosage group （5 mL/kg）, 1/2 dosage group （7.5 mL/kg）, and total dosage group （15 mL/kg）.Plasma levels of CK, CK-MB, LDH, cTnI, ET-1 were measured before aortic cross-clamp and after wean-off cardiopulmonary bypass （CPB）.The ratio of spontaneous cardiac rhythm recovery, dose of inotropic drugs application, CPB time, aortic cross-clamp time, mechanical ventilation support time and ICU stay-time were recorded.Results All the patients were healed and dis-charged after heart re-beat.The ratio of spontaneous cardiac rhythm recovery, CPB time, aortic cross-clamp time, mechanical ventilation support time and ICU stay-time had no statistic differ-ence between three groups.Conclusion It is reliable and effective to use different dose of cold crystalloid hyperkalemic cardioplegia in infants with VSD undergoing open heart surgery.

关 键 词：心脏停跳液 心肌保护 室间隔缺损 婴幼儿 

分 类 号：R654.1[医药卫生—外科学]