温血诱导及冷血停搏液持续灌注对婴幼儿的心肌保护作用

目的:探讨温血诱导心停搏加冷血停搏液持续灌注对婴幼儿心脏手术的心肌保护作用。方法:选择体外循环心内直视手术的婴幼儿20例,随机分为两组:冷血停跳液间断灌注组;温血诱导心停搏加冷血停搏液持续灌注组(观察组)。检测于手术前后白细胞β2整合素(CD11b)表达,TNF-α和心肌钙蛋白I(cTnT)含量。观察自动复跳率(例),后并行时间,术后心功能,术后正性肌力药物用量。结果:两组相比,对照组CD11b表达增强(P<0.01),TNF-α和cTnI含量增高(P<0.01)。对照组后并行时间,术后正性肌力药物用量显著高于观察组(P<0.05);自动复跳率(例),心功能指标明显低于观察组(P<0.05)。结论:温血诱导心停搏加冷血停搏液持续灌注技术对婴幼儿心脏手术比冷血停搏液间断灌注有更好的心肌保护效果。

The Myocardium Protection of Warm Induction and Continuous Perfusion by Cold Blood Cardioplegia on Infants

Objective:To investgate the myocardium protection of warm induction and continuous perfusion cold blood cardioplegia on infants.Methods:Twenty pediatric patients were divided into two groups randomly:Group of warm blood (warm induction and continuous perfeusion by cold blood cardioplegia,n=10);Gourp of cold blood(n=10).The effect of myocardium protection of the two kinds of cardioplegic methods are evaluated by clinical outcome,CD11b,TNF-α and cTnI.Results:Compared with the group of cold blood,the expression of CD11b and the concentration of TNF-α and cTnI in the group of warm blood are significantly lower(P<0.01);The percentage of myocardial auto-resuscitation in the group of warm blood is significantly higher than that in the group of cold blood(P<0.05).Conclusions:The technique of warm induction and continuous perfusion by cold blood cardioplegia provides more myocardium protection than simple cold blood cardioplegia in infants.