心脏手术麻醉过程中温血灌注与冷晶体灌注对心肌保护作用的对比研究

目的　研究心脏手术麻醉过程中温血灌注液和冷晶体灌注液对心肌的保护作用。方法　选择 2 0例体外循环心内直视手术的老年患者 ,随机分为 2组 :I组 ,温血组 ,给予 37℃温血全钾和温血半钾灌注液 ;II组 ,冷晶组 ,给予4℃常规的冷晶体灌注。两组分别于体外循环机转动前、停机后 12h、术后 2 4h抽血测定血清谷草转氨酶 (GOT)、乳酸脱氢酶 (LDH)、肌酸磷酸激酶 (creatinekinase ,CK)和肌酸磷酸激酶同工酶 (CK MB) ,检测心脏复跳情况。结果　两组体外循环机转机时间和阻断时间无统计学差异 (P >0 0 5 ) ;温血组复跳情况优于冷晶组 ;温血组GOT、LDH、CK和CK MB的升高低于冷晶组 ,有显著性差异 (P <0 0 5 )。结论　温血全钾和半钾灌注方法明显优于冷晶体灌注液对心肌的保护作用 ;温血灌注方法是一种有效、实用的心肌保护法

A clinical comparative study of warm blood cardioplegia modified potassium versus cold crystalloid cardioplegia

Objective In the course of anaesthesia of tha cardiac operation, study the difference of the myocardial protection effects of warm blood cardioplegia plus potassium and the cold crystalloid cardioplegia. Methods Evaluate 20 consecutive old patients who underwent open heart surgery. The patients were randomly divided into two groups. One is Group I(WBC), who received warm blood cardioplegic solution modified by full or half potassium, and the other is Group II(CCC), who received cold crystalloid cardioplegia. Analysed the changes of plasma GOT, Lactate dehydrogenase(LDH), Creatine kinase(CK) and CK MB. The bypass time and the observation of resuscitation were also undertaken at the same time. Results Comparison of groups I and II showed similar bypass time and the state of resuscitation, and no differences between groups were detected. In both groups, GOT, LDH, CK and CK MB increased throughout the reperfusion period, but the value of them were significantly higher in the CCC group. Conclusion WBC affords better protection to the myocyte that CCC, and is an effective, cheap and practical myocardial protection technique.