体外循环温度对冷晶体停搏液心肌保护效果的影响

目的：研究冷晶体停搏液在不同体外循环温度情况下对学龄前儿童心肌的保护效果。方法：将40例学龄前儿童分为浅低温组（20例）和常温组（20例），分别在浅低温和常温体外循下行室间隔缺损修补术，术中均采用冷晶体液间断灌注保护心肌，观察心脏诱导停跳时间，术中心电活动情况，体外循环前后心肌酶谱变化等指标。结果：常温组心脏诱导停跳时间延长，术中出现心电活动的概率和体外循环后肌酶激酶（CK）、肌酸激酶同工酶（CK－MB）及乳酸脱氢酶（LDH）升高值均高于浅低温组。结论：在学龄前儿童先天性心脏病矫治术中，浅低温体外循环时冷晶体停搏液间断灌注具有较好的心肌保护效果。

The effect of different temperature CPB with on the myocardial preservation cold crystalloid cardioplegia

Objective: To study the effect in different temperature cardiopulmonary bypass (CPB) on the myocardial preservation with cold crystalloid cardioplegia in preschool children with congenital heart disease.Methods:40 cases of preschool children with ventricular septal defect underwent surgical treatment with cold crystalloid cardioplegia intermittent perfuse as myocardial preservation. These cases were divided into two groups according to the management method:mild hypothermia group,in which 20 patients were treated with mild hypothermia CPB and Normothermic group,in which 20 patients were treated with normothermic CPB. The process of heart arrest, the incidence of electro-mechanical activity during heart arrest and the change of myocardium enzymes after operation were compared between the two groups.Results:The process of heart arrest was longer and the incidence of electro-mechanical activity during heart arrest, the increased value of CK,CK-MB,LDH after operation in Normothermic group were higher than those of mild hypothermia group.Conclusion:Cold crystalloid cardioplegia and mild hypothermia CPB is still an effective and safe strategy to protect the myocardium during congenital heart disease operation in preschool children.