【摘要】 目的初步评价体外循环含钾温血持续灌注心肌保护方法的临床价值。方法对31例先天性心脏病患者(温血组)实施室间隔缺损修补术,采用体外循环含钾温血持续灌注的心肌保护方法。30例先天性心脏病患者(冷血组)实施室间隔缺损修补术,采用体外循环冷血间歇灌注心肌保护。观察两组心脏除颤率、开放主动脉后血钾、术后呼吸机辅助时间及心肌正性肌力药物使用情况。结果温血组与冷血组比较,开放主动脉后心脏除颤率比较差异有显著性(3.2%与26.7%,P<0.01);心肌正性肌力药物使用时间差异亦有显著性(P<0.01);术后心功能恢复快,无术后高血钾、低心排血量、严重心律失常等严重并发症。结论体外循环含钾温血持续灌注心肌保护方法可明显减轻心肌缺血与再灌注损伤,先天性心脏病手术中温血持续灌注的心肌保护效果优越,值得推广应用。更多还原

【Abstract】 Objective To evaluate the protective effect of continuous potassic warm blood perfusion on myocardium during cardiopulmonary bypass.Methods Compared with the intermittent cold blood perfusion group(CBP)(n=30),continuous potassic warm blood perfusion (WBP)for myocardial protection was used in 31 cases subjected to repairing of ventricular septal defect.Defibrillation rate,serum potassium after the open of aortic artery and the supporting time of respiratory and positive inotropic agents were observed after aortic cross-clamp removal.Results There was significant difference in defibrillation between warm blood perfusion group and cold blood perfusion group(3.2% vs.26.7%,P<0.01) after aortic cross-clamp was removed; The time for use of myocardial positive inotropics was significant difference(P<0.01).There were not serious complications such as high serum potassium 、low cardiac output and arrhythmia.Conclusion Myocardial protection of continuous potassic warm blood perfusion can prevent myocardial ischemia and reperfusion injury,which effect is superior in the congenital heart disease operation.更多还原