一体化综合性心肌保护对婴幼儿心肌超微结构的保护

目的：观察一体化综合性心肌保护方法对婴幼儿心肌超微结构的影响以评价其心肌保护效果。方法：30例复杂先天性心脏病患儿随机分成一体化综合性心肌保护组（综合组，含温血停搏液诱导停搏，冷血停搏液间歇灌注和终末温血灌注液复苏）、冷血停搏液间断灌注组（冷血组），及冷晶体停搏液间断灌注组（冷晶组），各10例。于心脏停跳即刻、缝合右心房切口前分别取小块右心房肌肉作光镜及电镜观察，并对线粒体、细胞核、肌纤维进行定量评估。结果：三组心肌均存在不同程度的损伤，冷晶组最重，综合组最轻。心肌超微结构评分在三组之间两两比较较有统计学意义（P〈0．01或P〈0．05）。结论：一体化综合性心肌保护作用优于冷血停搏液和冷晶体停搏液。

Effect of integration myocardial protection for cardioplegia in infant

To study the effect of integration myocardial protection(IMP)in infants.Methods:Thirty patients with congenital heart disease(CHD)were randomly divided into three groups:IMP group[contain warm blood eardio- plegia solation induction,cold blood cardioplegia(CBC)fluid interval reperfusion,and finish warm blood reperfusion fluid resuscitation,n=10] ,CBC group(n=10) and cold crystalloid cardioplegia group(CCC group,n=10) .The myocardial ultrastructure was obsered.The ultrastruetural changes of the myocardium were analyzed with semiquanti- tatives coring system and classified as mild,moderate or severe.Results:The myocardial ultrastructure change of IMP group was mild.Compared with IMP group,ultrastructure of the right atrial myocardium showed severe damage (P<0. 01) in CCC group,moderate damage(P<0. 05) in CBC group.Conclusion:Method of integration myocardial protection appears to be superior to cold blood and cold crystalloid cardioplegia.