温氧合自体血高钾持续灌注对心肌保护作用的临床观察  

Clinical study of myocardial protection by continuous of warm oxygenated blood plus potassium

作　　者：周庆玲[1] 陈忠堂[1] 孙强[1] 张永善[1] 陈庆伟[1] 鲍卫国[1] 

机构地区：[1]山东大学第二医院,山东济南250033

出　　处：《山东医药》2002年第15期4-5,共2页Shandong Medical Journal

摘　　要：为观察全身浅低温 (30～ 32℃ )体外循环 (CPB)下温氧合自体血加高钾经主动脉根部持续灌注对心肌的保护效果 ,用该法对 30例心脏手术患者进行心肌保护 (WBC组 ) ,并与 30例用冷晶体间断灌注行心肌保护者(CCC组 )进行对比 ,观察两组围术期血清心肌酶、心肌超微结构及相关临床变化。结果显示 ,术后各时点 WBC组肌酸磷酸激酶 (CK)、肌酸磷酸激酶同工酶 (CK- MB)均显著低于 CCC组 ,P<0 .0 5 ;WBC组心肌超微结构改变轻微 ,术后自动复跳率高 ,正性肌力药物用量少 ,且未发现术后高血钾。提示浅低温 CPB温氧合血高钾持续灌注对心肌有明显保护作用 ,且晶体液用量较少 。To evaluate the myocardial protection effect by continuous perfusion of warm blood plus potassium during mild hypothermic (nasopharyngeal temperature 30～33℃) cardio pulmonary bypass (CPB) 60 patients undergoing elective open heart surgery with similar clinical data were randomized to receive intermittent crystalloid cardioplegia (CCC group,n=30)and continuous perfusion of warm oxygenated blood plus potassium for myocardial protection (WBC group,n=30) Compared with CCC group ,WBC group had less CK, CK MB release postoperatively,mild alterations in myocardial histology, higher rate of spontaneous return to sinus rhythm and less and short duration of inotropic use These suggest that continuous perfusion of warm oxygenated blood plus potassium can provide satisfactory myocardial protection during mild hypothermic CPB and avoid over hemodilution and overload of crytolloid solution

关 键 词：冷晶体停跳液 氧合自体血 心肌保护 浅低温 体外循环 

分 类 号：R654.1[医药卫生—外科学]