【摘要】 探讨心脏不停跳法防止心瓣膜替换术后低心排血量综合征机理。方法检测冠脉循环与体循环血氧分压、氧饱和度、pH值、K~+、过氧化脂质(LPO),观察术后血流动力学变化。结果冠循环与体循环的pH值、K~+基本一致;LPO在开放主动脉阻断后15分钟与开放阻断前比较无显著性差异(P>0.05);心脏手术完毕即可停机,术后无低心排血量综合征发生。结论心不停跳心内直视手术能避免心肌缺血缺氧损伤和再灌注损伤,有效地防止因心肌保护不良引起的术后心功能不良和低心排血量综合征。更多还原

【Abstract】 To detect the mechanism of beating heart method against low cardiac output syndrome after valve replacement surgery. Methods PO₂, O₂ sat, pH, K⁺ and peroxidation products （LPO） of coro- nary circulation and systemic circulation were determined in 39 patients undergoing heart valve replace- ment in beating heart and the changes in postoperative hymodynamics observed. Results No difference was found in the values of pH and K⁺ between coronary circulation and systemic circulation. The level of LPO was not changed significantly 15 min and 30 min after the removal of aortic cross-clamp （P> 0.05）. The pump was stopped smoothly as open heart surgery finished. No postoperative low cardiac output syndrome happened. Conclusion Open heart surgery in beating heart can avoid ischemic damage and reperfusion injury, and effectively prevent pump failure and low cardiac output syndrome due to poor myocardial protection during the operation.更多还原