冷血停搏液对法洛四联症婴幼儿心肌代谢的影响

目的：通过临床应用，评价冷血停搏液对未成熟心肌代谢的影响。方法：50例行择期法洛四联症根治术病儿随机分为2组，对照组用10℃改良St.Thomas 1停搏液（CCP），试验组用冷血停搏液（BCP），阻断升主动脉前，开放升主动脉1，3，10min分别由冠状静脉窦和动脉同时取血测定血气，电解质，乳酸，丙二醛（MDA）等含量。结果：再灌注后BCP组心肌氧提取率，乳酸摄取率恢复较快（P＜0．05），再灌注各时点两组均出现钾离子释放和MDA升高；再灌注后BCP组钙离子摄取较低（P＜0．05），结论：冷血停搏液对再灌注后的离子平衡，氧化谢，糖代谢恢复优于冷晶体停搏液。

The metabolic consequences of cold blood and crystalloid cardioplegia in cyanotic congenital heart disease

Objective: To compared the metabolic consequence of cold crystalloid with cold blood based St. Thomas' Hospital cardioplegic solution No.1 in children with tetralogy of Fallot. Methods: A consecutive series of 50 children who underwent selective operation were randomly assigned to crystalloid or blood based cardioplegia. The groups matched in respect to sex, age, body surface area and preoperative ventricular function. Blood gas, electrolytes, lactate, MDA were determined simultaneously in arterial and coronary venous sinus blood sample before clamping, and 1,3,10 min immediate after unclamping at 1,3,10 minutes. Results: In the blood cardioplegia group, the lactate and oxygen extraction change recovered rapidly after unclamping (P<0 05), and the calcium uptake were decreased (P<0 05). The potassium release were increased during reperfusion in both groups, but no potassium release and MDA difference were noticed in the two groups. Conclusion: Cold bloo based St. Thomas' Hospital cardioplegic solution No.1 appears to be advantageous at the myocardium metabolism in the children with tetralogy of Fallot.