温血心肌停搏液微流量连续灌注法在老年心脏病患者中的应用  

Myocardial protection with continuous mini-flow warm blood cardioplegia in elderly heart defects

作　　者：张瑞成[1] 张大新[1] 庄世才[1] 法宪恩[1] 赵根尚[1] 冯德广[1] 初佩俊[1] 

机构地区：[1]郑州大学第二附属医院心血管外科,河南郑州450003

出　　处：《河南医学研究》2003年第4期340-341,共2页Henan Medical Research

摘　　要：目的 :探讨温血心肌停搏液微流量连续灌注法在老年心脏直视手术中的应用效果。方法 :本组 3 4例 ,年龄 60～ 71岁。病种包括先天性房间隔缺损 5例 ,心脏瓣膜病 2 8例 ,左心房粘液瘤 1例。阻断升主动脉 ,先用含钾 2 3～ 2 8mmol/L的温血停搏液诱导心脏停搏 ,再用含钾 6～ 8mmol/L温血停搏液以 0 5～ 1 0ml/kg·min速度连续灌注至开放主动脉阻断钳前 ,心肌温度维持在 3 2℃～ 3 6℃。心脏病变给予矫治。结果 :阻断升主动脉灌注含钾温血停搏液后 ,心脏停搏迅速 ,且不经心室颤动阶段。开放升主动脉后 3 3例( 97 1% )自动恢复为窦性心律 ,血管活性药物用量小 ,无低心排及严重心律失常发生。死亡 1例。结论 :温血心肌停搏液微流量连续灌注法对老年心脏病手术患者效果较好 ,是一种安全、可靠的心肌保护方法。Objective: To summarize the effects of myocardial protection with continuous mini_flow warm blood cardioplegia in elderly heart defects.Methods: From Sept.1995 to Nov.2002,34 cases,aged 60 to 71 years,underwent open heart surgery.Low potassium warm blood cardioplegia was perfused continuously at a rate of 0.5～1.0 ml/kg·min after the hearts arrested with hyperkalemia warm blood cardioplegia.Myocardial temperature kept at 32 ℃～36 ℃.Results: All the hearts arrested rapidly without ventricular fibrillation after perfusion of hyperkalemia cardioplegia.97.1% of the hearts resumed normal sinus rhythm spontaneously after aortic declamping.No low output syndrome and severe arrhythmia occurred.1 case died.Conclusion: The method of myocardial protection with continuous mini_flow warm blood cardioplegia in elderly heart defects is safe,effective and reliable.

关 键 词：温血心肌停搏液 微流量连续灌注法 老年患者 心脏病 心脏直视手术 

分 类 号：R654.2[医药卫生—外科学]