浅低温体外循环间断灌注的心肌保护效果观察

探讨浅低温体外循环温血间断灌注心肌保护的临床效果,提高瓣膜置换、冠脉搭桥手术的成功率。方法①浅低温体外循环温血高钾持续灌注心肌保护为对照组(A,n=53);②浅低温体外循环温血高钾间断灌注心肌保护为实验组(B,n=75)。观察两组临床结果并进行比较。结果体外循环时间、主动脉阻断时间B组明显少于A组;库血用量和24h胸腔引流量B组明显少于A组;主动脉开放前血钾浓度B组明显低于A组;主动脉开放后心脏自动复跳率B组明显高于A组。结论浅低温体外循环温血高钾间断灌注保护心肌效果显著,方法简单可行。

The clinical effect of intermittent warm blood perfusion under shallow hypothermia CPB for myocardial pretection

Objective To evaluate the myocardial pretection effect of intermittent warm blood perfusion under shallow hypothermia CPB in valve replacement and CABG.Methods(1)Group A comprised53cases with persistent warm blood(with hyper-kalium)perfusion under shallow hypothermia CPB as controlled group.(2)Group B comprised75cases with intermittent warm blood(with hyper-kalium)perfusion as experimental group.The clinical effect of two groups was observed and compared.Results The CPB time and aortic arresting clamping time of group B was clearly shorter than that of group A.The volume of banked blood and drainage from thoracic cavityin24hours of group B was obviously less than that of group A.The pre-opening-aortic blood kalium concentration of group B was markedly lower that of group A.The post-opening-aortic autorebeating rate of group B was remarkably higher than that of group A.Conclusion The myocardial pretection effect of intermittent warm blood(with hyper-kalium)perfusion under shallow hypothermia CPB is significant,and it is easy performed and feasible.