氧合温血停搏液对心肌保护的临床与基础研究

目的：观察氧合温血停搏液对心脏直视手术缺血期间的心肌保护作用。方法：选取30例病人，分为3组，对照组、氧合温血组、氧合温血加1，6二磷酸果糖组（简称FDP组）各10例。观察3组术前、术后12h、术后24h心肌酶谱的动态变化；心脏停跳后10min、30min及升主动脉开放前3个时相的心肌超微结构的改变；术毕心脏自动复跳率的变化。结果：对照组心脏均经室颤停跳，其余两组均不经室颤且心脏自动复苏率明显高于对照组。心肌酶谱变趋势显示对照组释放峰值高于氧合温血组及FDP组，下降也低于其余两组。电镜观察显示氧合温血组及FDP组保存了较好的心肌超微结构。结论：氧合温血及FDP具有心肌保护作用。

Warm blood cardioplegia for myocardial protection in open heart surgery

Objective: To examine the cardioprotection efficacy of warm blood cardioplegia in patients undergoing open heart surgery.Method: 30 patients undergoing open heart surgery were randomly assigned to receive cold crystalloid cardioplegia, warm blood cardioplegia and Fructose-diphosphate(FDP) added to warm blood cardioplegia. Cadicenzymes including AST, ALT, LD, CK, were measured in serial arterial blood samples drawn before and 12h, 24h, after operation. The ultrastracture of myocardium were observed 10 minutes, 30 minutes after cardiac arrest and just before aortic unclamping by right atrium biopsies. Results: Cardiac arrest were achieved via ventricular fibrillation in all patients received cold crystalloid cardiplegia, while in other two groups cadiac arrest were achieved without ventricular fibrillation. A higher rate and better myocardial ultrastruture preservation were observed in warm blood cardioplegia group and FDP group. The serum level of cardicenzymes in cold crystalloid cardioplegia group were higher than that of two other groups. Conclusion: Warm blood cardioplegia and Fructose-diphophate can improve myocardial protection.