心脏晶体停搏液和冷血停搏液不同灌注方法对心肌保护的评价  

Comparitive Study of Myocardial Protection with Crystalloid and Blood Cardioplegia

作　　者：钱金兰[1] 李欣[1] 吴金宝[1] 徐新根[1] 邱兆昆[1] 

机构地区：[1]上海市胸科医院体外循环室,200030

出　　处：《上海生物医学工程》2003年第4期40-42,共3页Shanghai Journal of Biomedical Engineering

摘　　要：目的 :评估二种心脏停搏液不同灌注方法对心肌保护作用。方法 :30例双瓣患者随机分为冷晶体停搏液间断灌注组 (n=1 0 ) ,冷血停搏液间断灌注组 (n=1 0 ) ,冷血停搏液持续灌注组 (n=1 0 ) ,观察血浆心肌肌钙蛋白 T(Cn T)、肌酸激酶 (CK)、肌酸激酶同工酶 (CK- MB)。结果 :体外循环后冷晶体停搏液间断灌注组血浆心肌肌钙蛋白 T和肌酸激酶、肌酶激酶同工酶较其他 2组明显增高 ;冷血停搏液间断灌注组和冷血停搏液持续灌注组血浆心肌肌钙蛋白 T、肌酸激酶、肌酸激酶同工酶无明显差异。结论 :冷血停搏液的心肌保护优于冷晶体停搏液 ,冷血停搏液间断灌注与持续灌注没有明显差异。Objective:To evaluate the effects of two kinds of cardiopegia on open heart surgery.Methods:Thirty patients with double vavular disease underwent valve replacement were randomized divided into cold crystalloid cardioplegia(CC group,n=10),intermittent cold blood cardioplegia (CBC group,n=10),continuous cold blood cardioplegia.The plasma cardiac troponin T(cTnT),creatine kinaes (CK),creatine kinaes MB(CK MB)were tested.Results:The cTnT concentration increased significantly greater(P<0 01) in the CCgroup than in the other groups during postoperation.Conclusion:The measurment of cTnT is a sensitive and specific method for the diagnosis of myocardial injury in open heart surery of pediatric patients.It can avoid the high incidence of false diagnosis with the use of CK,and CK MB as a diagnosis markers.Cold blood cardioplegia appear to be superior to cold craystalloid cardioplegia.

关 键 词：心脏晶体停搏液 冷血停搏液 灌注方法 心肌保护 双瓣替换术 

分 类 号：R654.2[医药卫生—外科学] R982[医药卫生—临床医学]