温血高钾间断灌注心肌保护的临床应用

目的　探讨浅低温体外循环 (CPB)温血间断灌注心肌保护的临床效果。方法　全组随机分为对照组 (A组 )6 8例 ,采用浅低温CPB温血高钾持续灌注心肌保护。实验组 (B组 ) 91例 ,采用浅低温CPB温血高钾间断灌注心肌保护。观察两组术中心肌保护效果的差别。结果　CPB时间、主动脉阻断时间B组明显小于A组 (P <0 .0 5 ) ;库血用量和 2 4h胸腔引流量B组明显少于A组 (P <0 .0 5 ) ;主动脉开放前血钾浓度B组明显低于A组 (P <0 .0 5 ) ;主动脉开放后心脏自动复跳率B组明显高于A组 (P <0 .0 5 ) ;术后心功能临床观察两组无显著差异。结论　浅低温CPB温血高钾间断灌注保护心肌效果良好。

The Clinical Use of High- Potassium Warm Blood Infusion to Protect Myocardium

OBJECTIVE To investigate the myocardial preservation effect of intermittent warm blood perfusion under low hypothermia CPB. METHODS Patients were randomly divided as follows: Control gronp comprised 68 cases with continuous warm hyperkalemia perfusion under low hypothermia CPB ; experimental group comprised 91 cases with intermittent warm hyperkalemia perfusion. Clinical effects were observed and compared the. RESULTS The CPB time and aortic arresting time of group B was clearly shorter than that of group A.The dosage of banked blood and drainge in 24 hours of group B was obviously less than that of group A.The pre-aortic-opening blood potassium concentration in group B was markedly lower than of group A. The post-aortic-opening auto-rebeating rate of group B was remarkblly higher than that of group A,After operation no remarkable differenc in the function of heart was found e in two groups. CONCLUSION The myocardial preservation effect of intermittent warm hyperkalemia perfusion under low hypothermia CPB is satisfactoly.