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体外循环停跳与不停跳心内直视手术的对比研究
引用本文:凌庆,陈华蓉,温定国. 体外循环停跳与不停跳心内直视手术的对比研究[J]. 中国体外循环杂志, 2003, 1(4): 206-209
作者姓名:凌庆  陈华蓉  温定国
作者单位:1. 深圳市第一人民医院,暨南大学医学院第二附属医院心外科,广东,深圳,518020
2. 深圳市第一人民医院,暨南大学医学院第二附属医院肾内科,广东,深圳,518020
摘    要:
目的本研究测定体外循环(CPB)术中、术后心肌酶的变化,观察心肌细胞超微结构的改变,了解术后升压药及库血的用量。方法60例接受心内直视手术的病人随机分为不停跳组(实验组)和停跳组(对照组)。两组间术前心功能等指标无显著差异。效果评价包括:心肌酶、心肌超微结构半定量分析,升压药(多巴胺)及库血用量分析。结果心肌磷酸肌酸激酶(CK)及其同功酶(CK—MB)、乳酸脱氢酶(LDH)、天门冬氨酸氨基转换酶(AST)两组病例在术后均升高(P<0.01),停跳组比不停跳组峰值提前,且持续时间长。心肌超微结构显示停跳组比不停跳组改变明显。术后升压药用量及库血用量对照组高于实验组(P<0.01)。结论CPB下不停跳心内直视手术在心肌保护方面优于停跳组,且库血用量、升压药用量亦明显减少。

关 键 词:体外循环 心肌酶 心肌细胞 超微结构 心肌保护 心脏停跳 心脏不停跳
文章编号:1672-1403(2003)04-0206-04
修稿时间:2003-02-25

Comparison of Enzyme Study and Ultrastructure of Myocardium during Cardiopulmonary Bypass with Beating and Arrested Heart
LING Qing,CHEN Hua -rung,WEN Ding -guo. Comparison of Enzyme Study and Ultrastructure of Myocardium during Cardiopulmonary Bypass with Beating and Arrested Heart[J]. Chinese Journal of Extracorporeal Circulation, 2003, 1(4): 206-209
Authors:LING Qing  CHEN Hua -rung  WEN Ding -guo
Abstract:
OBJECTIVE To explore the myocardial protection with beating and arrested heart during cardiopulmonary bypass(CPB). METHODS 30 patients were operated under beating heart surgery with CPB. Another 30 patients were operated under arrested heart surgery with CPB. Indexes, such as myocardial enzymes and myocardial ultrastucture and doses of vasopressor were observed after operation with beating heart , comparing to arrested heart. RESULTS The enzymes were high in both gronps. The myocardial ultrastructure was better preserved with beating heart operation. CONCLUSION Shoored better myocardcal preseroatcon Enzyme study and ultrastructure of myocardium.
Keywords:cardiopulmonary bypass  myocardial ultrastructure  myocardial enzyme
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