间断缺血心停搏在冠脉搭桥术中的应用

１９９２～１９９３年间为１８０例冠脉病变的病人施行冠脉搭桥术，全部病人均采用核甙抑制剂利多氟嗪预处理和低温（２８℃）间断缺血心停搏进行术中心肌保护。平均每例病人作冠状动脉端吻合３～４个，每个吻合口用９分钟，主动脉阻断累加时间约２５分钟，体外循环时间９０分钟，术后医院死亡率１．６％（３／１８０），无术后心梗发生。作者认为，冠脉搭桥术的术中心肌保护可采用核甙抑制剂和间断缺血心停搏方法，而不用心肌停搏液。

The Application of Intermittent Ischemia for Myocardial Protection during Coronary Artery Bypass Graftion

Aim:To evaluate the myocardial protective effect of intermittent ischemic cardiac arrest during coronary artery bypass grafting.Material and Method:From 1992 1993,180 patients with coronary arterial disease were operated upon in the Department of Cardiac Surgery,Gasthuisberg Hospital,Leuven Catholic University,Belgium.The patients were premedicated with nucleoside depressant,lidoflazine.The heart was subjected to intermittent ischemia arrest at hypothermia of 28 C by intermittent aortic cross clamping and the coronary arteries were reperfused in between the ischemic intervals.The mean total aortic cross clamping time was 25 minutes,and the mean cardiopulmonary time was 90 minutes.The overall postoperative in hospital mortality was 1.6%(3/180),and there was no perioperative infarction.The authors consider that premedication of lidoflazine and short period of intermittent ischemic cardiac arrest supplemented with intermittent coronary reperfusion as a safe myocardial protection procedure ofr CABG.Cardioplegic solution is not necessary.