【摘要】 目的　评价常温体外循环心脏不停跳心内直视手术。方法　应用体外循环动物模型进行研究 ,将牛随机分为两组 ,每组 6头。 组为低温体外循环冷晶体停搏心内直视手术组 , 组为常温体外循环心脏不停跳心内直视手术组。结果　尽管阻断钳开放后两组血清肌酸磷酸激酶同工酶 (CK- MB)均有所升高 ,但组间比较 组代表心肌损伤的各项指标均优于 组 : 组阻断钳开放即刻及开放后 3 0 min血清 CK- MB、丙二醛 (MDA)显著高于 组 ,三磷酸腺苷 (ATP)显著低于 组 ;而代表血细胞破坏情况的血浆游离血红蛋白 组显著低于 组。结论　常温心脏不停跳心内直视手术避免了低温和缺血再灌注损伤引起的心肌损害 ,具有明确的心肌保护作用 ,但仍存在一定的心肌损伤。另外 ,这种手术方式存在血液成分破坏较重的不足更多还原

【Abstract】 OBJECTIVE To evaluate the normothermic operation on beating heart during cardiopulmonary bypass. METHODS Twelve cattles were divided randomly into 2 groups. Ⅰ:the cold crystalloid cardioplegia group(n=6); Group Ⅱ: the normothermic beating heart group(n=6). RESULTS Although the postoperative level of serum CK MB of both groups heightened, the titers of serum CK MB and MDA (melodiadehyde) in groupⅠ were significatly higher than group Ⅱ, and ATP (adenosine triphosphate), free plasma hemoglobin in group Ⅰ were lower than group Ⅱ at the time of aortic clamp release and 30 minutes after release. CONCLUSIONS Operation on beating heart during normothermia CPB has definite effect on myocardium protection, but the destruction of blood constituents remains the main problem.更多还原