温血停搏液持续逆行灌注对心肌保护作用

目的研究温血停搏液经冠状静脉窦持续灌注对心肌保护作用。方法60例心脏瓣膜病患者，随机分成两组：持续灌注组(实验组n=30)和间断灌注组(对照组n=30)。术中测定心肌酶及取心肌组织电镜观察超微结构。结果对照组与实验组相比，心肌酶峰值提前，且持续时间较长。心肌超微结构显示：对照组心肌细胞线粒体出现普遍空泡化，部分嵴溶解。结论温血心肌停搏液持续逆灌对心肌保护作用优于间断灌注组，适合重症心脏病心瓣膜置换术患者。

Myocardium Protection with Warm Blood Cardioplegia Under Continuous Retrograde Perfusion

OBJECTIVE To evaluate the myocardial protection using continuous retrograde conorary sinus perfusion with warm blood cardioplegia(WBC).METHODS Sixty patients with valvular disease were randomly divided into two groups:a study group who received continuous retrograde warm blood hyperkalemia cardioplegia, and a control group who received cold blood hypokalemic cardioplegia,30 patients in each group. Cardiac enzymes were taken during the operation and cardiac tissue biopsies were incised for observation of myocardial ultrastructure under electrical microscope.RESULTS Compared with the study group, the peak of the cardiac enzymes appeared earlier and lasted longer in control group. The cardiac ultrastucture study showed that the myofibris and mitochondria damages were serever in the control group. CONCLUSION The myocardial protective effect under contious retrograde warm blood cardioplegia perfusion was better than that under intermittent blood cardioplegia perfusion. The method is suitable for critical patients undergoing valev replacement surgery.