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常温体外循环温血心停搏液持续灌注心肌保护的实验研究 |
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肖学钧 张镜方 章晓华 陈 萍 范瑞新 丁以群 罗征祥
【摘要】 目的 为了探讨常温体外循环温血心停搏液持续灌注心肌保护的机理。方法 15条犬随机分成三组，在体外循环下分别灌注三种不同的心停搏液，对三种不同的心肌保护方法进行对比观察。结果 温血心停搏液灌注液(C组)的CK-MB、LDH、MDA及钙离子含量在心脏再灌注30 min时均明显低于冷晶体(A组)及冷血心停搏液灌注组(B组)(P＜0.05)；而ATP含量则明显高于A、B两组(P＜0.05)。心肌超微结构检查也显示C组心肌无明显缺血损伤。结论 常温体外循环温血心停搏液持续灌注心肌保护的效果良好。
【关键词】 心肌保护 温血心停搏液 持续灌注 常温体外循环
Experimental study of warm blood continuous cardioplegia for myocardial protection during normothermica cardiopulmonary bypass
Xiao Xuejun,Zhang Jinfang,Zhang Xiaohua
et al Guangdong Provincial Cardiovascular Institute,Guangzhou 510100
【Abstract】 Objective In order to explore the mechanism of warm blood continuous cardioplegia for myocardial protection during normothermic cardiopulmonary bypass.Methods we divided 15 dogs into three groups randomly,and perfused cold crystallid(group A),cold blood(group B)and warm blood(group C)cardioplegia respectively during cardiopulmonary bypass,and comparison of the results of the three different methods of myocardial protection.Results The results demonstrated that CK-MB, LDH, MDA and ion calcium content in myocardium were significantly lower at 30 minutes after cross-clamping release(CCR) in group C than that in group A and B(P＜0.05)，but the ATP content was significantly higher in group C than that in group A and B(P＜0.05).No significant myocardium ultrastructural changes were found in group C.Conclusion Warm blood continuous cardioplegia for myocardial protection during cardiopulmonary bypass was very satisfied and provided a certain theoretical basis for clinical application of this method.
【Key words】 Myocardial protection Warm blood cardioplegia Continuous perfusion Normothermic cardiopulmonary bypass
1990年Lichtenstein［1］首先报道了温血心停搏液持续灌注心肌保护常温心脏手术获得成功，嗣后国内外陆续有临床应用的报道［2～5］，然而，这种心肌保护方法的基础方面研究却报道较少。为此，我们观察和比较了体外循环(CPB)下持续灌注温血、间断灌注冷晶体以及氧合冷血三种不同心停搏液对犬心肌保护的作用，对其作用机理作一探讨。
材料与方法
1.实验动物分组。实验动物为杂种犬15只，体重20～25 kg，随机分[1] [2] 下一页
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