心脏不停跳法猪供心保存模型的建立

目的研究心脏不停跳法猪供心保存模型的建立，评述其意义及价值。方法选用25～30kg的广西巴马猪12头，6头只用于采血，6头取心脏作为供心模型。全麻下，胸部正中切口，全身肝素化（4mg／kg），从上腔静脉放血500ml；阻断并切断头臂干插灌注管，切断上腔静脉和右上肺静脉回收血液，灌注心脏停跳液使心脏停跳。切断降主动脉起始部和两大分支，取下的心脏经肺静脉和二尖瓣口置入左心室引流管。用自行组装的灌注装置连续灌注氧合温血液，维持心脏空跳8h。结果6只供心都完好地保存了8h，保存期间除了1例出现短暂的心房传导阻滞（2：1）外，其余无发生心律失常。红细胞压积从灌注1h（T1）到5h（T5）逐渐升高，从T7到T8逐渐降低；游离钙离子和钾离子有逐渐升高的趋势；pH和BE有逐渐降低的趋势。心脏不停跳保存灌注压变化从T1到T4灌注压力呈逐渐下降，以后就处于一个相对稳定的数值。冠状静脉血氧分压（56．62±6．93）mmHg。心脏表面无干燥或水肿现象。结论“广西巴马小型猪”是进行心血管系统疾病研究理想的实验动物，离体猪心不停跳模型的建立对移植供心保存的研究有更重要的意义和价值。

Beating heart model of pig for heart preservation

Objective To study the porcine beating heart model for heart preservation, review the meaning and value. Methods Twelve Bama pigs weighted 25 -30 kg were chosen,6 pigs were only used for sampling blood, hearts of another 6 pigs were used for donor heart models. Pigs underwent chest incision under anesthesia and general heparinication（4 mg/kg）. Then 500 ml blood were removed from the superior vena cava. Blocked and cut off the brachioeephalie anteries,inserted perfnsion tube and cut off the superior vena cava and right superior pulmonary, then vein blood eardioplegie solution infusion was performed for cardiac arrest. Cut off the beginning part of the deseending aorta and the two branches, the left ventricnlar drainage tube was insorted into removed heart via the pu/rnonary vein and opening of mitral valve. A deviee with continuous perfusion with oxygenated warm perfusion of blood was used for maintaining empty heart jump 8 h. Results Six hearts were well preserved for 8 hours. In addition to I ease of atrial conduction block （2：1 ） in a brief period, the others didn＇t be found arrhythmia. Hematoerit from the perfusion 1 hour （ T1 ） to 5 hours （T5 ） increased gradually, gradually decreased from T7 to Ts ; free caleiurn and potassium ions are gradually increasing trend; pH and BE have gradually decreased. Save beating heart perfusion pressure from T1 to T4 deereased perfusion pressure, then went in a relatively stable value. Coronary venous oxygen tension was （56. 62 ± 6. 93 ）mmHg. Heart surface had been found without drying or edema. Condusion ＂Bama miniature pig＂ is ideal for cardiovascular disease research laboratory animal, in vitro porcine model of heart beating donor heart preservation for transplantation research has more important meaning and value.