【摘要】 目的　观察三种方法对体外循环犬心肌在缺血前、缺血中及再灌注后的心肌结构变化，以评价其心肌保护效果。方法　１５ 只犬随机分成３ 组（ ｎ＝ ５） 分别灌注三种停搏液。在心肌缺血前，缺血后１２０ ｍｉｎ 及再灌注３０ ｍｉｎ 于右心室相同部位取心肌作光镜及电镜观察。电镜采用线粒体计数作半定量分析。结果　３ 组在缺血前、中及再灌注后光镜结构无明显改变。电镜结构线粒体半定量分析显示在缺血１２０ ｍｉｎ 及再灌注３０ ｍｉｎ 冷血停搏液间断顺灌组及血利钾停搏液及双向性灌注组心肌线粒体损伤轻于冷晶体停搏液组（Ｐ＜０－０５）。前两组之间无显著差异（ Ｐ＞ ０－０５）。结论三种方法均能提供较好的心肌保护，血利钾停搏液及双向性灌注组心肌保护效果同等于冷血停搏液间断顺灌组，优于冷晶体停搏液间断顺灌组。更多还原

【Abstract】 Objectives This study was designed to compare three methods of myocardial protection and to determine whetherthe method oflidocaine hyperpotassium blood cardioplegia antegrade arresting and continuous retrograde crystalloid cardioplegia perfusion was better than othertwo.Methods Fifteen adultdogs were placed on cardiopulmonary bypass and randomized to receive:1- Cold St.thomas hospitalcardioplegia antegrade arrestand intermittent antegrade delivery (control group one ,G1) ; 2- Cold blood cardioplegia antegrade arrest and intermit tentantegrade delivery (controlgroup two,G2) ;3- Lido caine hyperpotassium blood cardioplegia antegrade arrest and continuousretrogradecold St.Thomas hospitalcardio plegia delivery(experimental group ,G3)- All hearts were ischemiafor 120 min and reperfused for 30 min .Samples form right ventricle were taken for light and electron mi croscope before ischemia,120 min after ischemia and 30 min after reperfusion . The ultrastructural changes were analyzed with use of a semiquantitative scoring system . Results They were almostthe same before ischemia .At 120 min afterischemia and 30 min afterreperfusion ,ul trastrual changes were slighterin G2 and G3 than in G1 ( P< 0-05) .No significant differences were found be tween G2 and G3 .Conclusion Lidocaine Hyperpotas sium blood cardioplegia antegrade arrest and continuous cold crystalloid cardioplegia retrograde perfusion afford myocardial protection better than simple myocardial pro tection,equalto cold blood cardioplegia antegrade arrest and intermittent antegrade delivery.Itis convenient,does not interrupt operation procedure and worthy of being widely used in clinical cardiac operation .更多还原