钾—温氧合血持续顺灌心肌保护、不降温体外循环冠状动脉搭桥术

应用温血顺灌心肌保护法进行连续54例冠状动脉搭桥术,全部获得成功.54例中,男性45例,女性9例,年龄平均55.41±12.31岁(41～71岁),术前合并心肌梗塞者30例,合并高血压26例.选择性冠状动脉造影显示单支病变2例,2支病变11例,3支病变41例,左室射血分数平均为56.93±18.36%.CPB时间:141.7±52.5分,升主动脉阻断时间:83.5±24.2分.全部病例均未行人工降温,鼻咽温度因室温不同波动在33.5～37.0℃之间(平均36.5℃).每例搭桥数1～4根不等,全组平均2.44根.作者介绍了温血灌注的操作方法,讨论了应用该方法进行冠状动脉搭桥术的优越性.指出,单独应用温血顺灌亦能为冠状动脉搭桥术提供良好的心肌保护.本文还就温血持续灌注对术野及血钾的影响进行了探讨.

Continuous Antegrade Perfusion of Oxygenated Warm Blood with Potassium Myocardial Protection for Coronary Artery Bypass Grafts——with the Clinical Report of 54 Cases.

Consecutive 54 CABG were performed with continuous antegrade perfusion of oxygenated warm blood and potassium. There is no mortality in this group. Among these cases, 45 is male and 9 is female,mean age is 55. 41±12. 31 year-old (41-71). Thirty cases with single vessel lesion, 11 cases with double-vessel lesions and 41 cases with triple-vessel lesions. Mean LVEF is 56. 93±18. 36%.CPB time:141. 7±52. 5 min. Aortic clamp time:83. 5±24. 2 min. All cases without using hypothermia. The mean grafts performed were 2. 44(1-4). We introduced the warm perfusion technique in details and discussed the advantages of warm blood perfusion. In our opinion, we think antegrade perfusion can offer satisfying myocardial protection for CABG. We also discussed how to make a clear visualization under the condition of continuous blood perfusion.