自体冷血心脏停搏液婴儿体外循环心脏直视手术1050例

目的：探讨自体冷血心脏停搏液对婴幼儿体外循环心脏直视手术未成熟心肌细胞的保护作用。方法：选取年龄≤10个月行体外循环室间隔缺损修补术的患儿1380例,随机分成自体冷血停搏液组（A组,n=1050）、冷血停搏液组（B组,n=280）和晶体停搏液（HTK）组（C组,n=50）。于术前、术后1、12、24、48h分别测量左心室Tei指数、心脏指数（CI）及左心室射血分数（LVEF）,监测CI术中记录复跳时间及复跳率,正性肌力药物依赖情况。结果：A组自动复跳率及时间、正性肌力药物依赖均明显减少（P〈0.05）。A组CI及LVEF较B、C组升高更明显（P〈0.05）,A组左心室Tei指数较B、C组降低更明显（P〈0.05）。结论：自体冷血停搏液利于婴儿体外循环直视手术心脏功能恢复,对未成熟心肌有良好的保护作用,值得临床推广。

The 1050 cases of opening cardiac operation under cardiopulmulnary bypass (CPB) in infant with cold self-blood cardioplegia

Objective：To observe the protective effect of cold self-blood cardioplegia on immature myocardium in infant underwent opening cardiac operation by CPB. Methods：1 380 infantile patients underwent repairing of VSD by CPB were randomized into three groups. The 1 050 cases in group A were given cold self-blood cardioplegia. The 280 cases in group B were given cold blood cardioplegia. The 50 cases in group B were given HTK solution. Tei-index of left ventricular,car-diac index and LVEF examined after 1,12,24,48 h of cardiac operation. The clinic parameters including the auto-beating rate and time and the requirement of inotropics were documented during operation. Results：The auto-beating time and the requirement of inotropics in group A was significantly less than those groups（P0.05） . The CI and LVEF in group A were higher than those groups after operation（P0.05） . The Tei of left ventricular in group A were less than those groups（P0.05） . Conclusion：The cold self-blood cardioplegia is useful to the recovery of cardiac function underwent opening cardiac operation by CPB in infant.The cold self-blood cardioplegia is value for immature myocardial protection during cardiac operation by CPB.