自体冷血停跳液保护未成熟心肌的价值

目的研究自体冷血停跳液在婴幼儿心内直视手术中保护未成熟心肌的价值。方法婴幼儿（体重≤8k）非发绀型先天性心脏病30例，随机分为自体冷血（A组）、冷血（B组）和晶体（C组）停跳液组，每组10例。分别于术前，术毕，术后24、48h经桡动脉抽血检测心肌肌钙蛋白I（cTnI）及磷酸肌酸激酶同功酶（CK—MB），术中记录复跳时间、室颤发生率和自动复跳率，术后监测心脏指数（CI）。结果术后cTnI和CK—MB明显升高，以后逐渐下降，同组手术前、后比较，cTnI术毕明显升高（P〈0．01），CK—MB术后24h达到高峰（P〈0．05、P〈0．01）。A组与B组、C组比较，复跳时间、cTnI和CK—MB差异有统计学意义（P〈0．05、P〈0．01）；CIA组优于B和C组；室颤发生率和自动复跳率各组差异无统计学意义。B组与C组比较，复跳时间和cTnI差异有统计学意义（P〈0．05）；CIB组优于C组。结论自体冷血停跳液优于冷血和晶体停跳液，对婴幼儿心内直视手术保护未成熟心肌有重要价值。

The value of myocardial protection for infants in open heart operation by perfusing autoblood cardioplegia

Objective To study the value of myocardial protection for infants in open heart operation by perfusing autoblood cardioplegia. Methods There were 30 cases of infants with acyanotice congenital heart disease, including 2 cases of VSD, 11 of VSD＋PH, 9 of VSD＋ASD＋PH, 2 of ASD, 6 of VSD＋FPO. 30 infants were collected randomly and divided into autoblood cardioplegic solution group（group A）, blood cardioplegic solution group（group B ） and crystalloid cardioplegic solution group（group C ）. Radial blood was withdrawed to measure cTnl and CK-MB before and at the end of operation, 24 h and 48 h after operation. The time of heart recovery, the ratio of ventricular fibrillation and auto-recuperate to beat were recorded during operation. The cardiac index （CI） was monitored after operation. Results After operation cTnI and CK-MB increased and decreased gradually. Comparing in the same group cTnl increased immediately （P〈0.01） after operation and CK-MB increased at 24 h after operation （P〈0.05, P〈0.01）. The comparison among group A, B and C in the time of heart recovery, cTnI and CK-MB was significant difference（P〈0.05, P〈0.01 ）. CI in the group Awas best in the three groups. The ratio of ventricular fibrillation and auto-recuperate to beat were no different among three groups. The time of heart recovery and cTnI had significant difference between group B and group C （P〈0.05）. CI in group B was better than C group. Conclusion Autoblood cardioplegic shows important value to myocardial protection for infants in open heart operation comparing with crystalloid and blood cardioplegic solution, and has.