利多卡因高钾温血心停搏液对犬心电活动影响的实验研究

Experimental Study on the Effects of Lidocaine Hyperkalemia Warm Blood Cardioplegia on Electrocardia Action in Dogs

目的 观察利多卡因高钾温血心停搏液对犬心电活动的影响。方法 12 只杂种犬随机分为对照组、利多卡因组 (每组6只)。常规建立体外循环 (CPB), 对照组用 ST ThomasⅡ冷晶体心停搏液常规灌注, 首剂量 20 ml/kg, 每隔30 min复灌1次, 剂量为10 ml/kg, 共 4 次。利多卡因组用利多卡因高钾温血心停搏液, 仅灌注一次 (5ml/kg)。心脏停搏120 min, 辅助30 min, 停机后30 min结束实验。记录围手术期心电活动。结果 利多卡因组诱导心电停止时间显著短于对照组 (P<0 .01); 停搏期间的心电发生显著低于对照组 (P<0 .01); 再灌注心脏的自动复跳高于对照组 (P<0 .01)。室颤的发生低于对照组 (P<0. 01)。结论 利多卡因高钾温血心停搏液能够使犬心脏电活动长时间停止, 并能够防止再灌注后发生室颤和其它室性心律失常。

Objective To observe the effect of lidocaine hyperkalemia warm blood cardioplegia (LHKWBCP) on dog electrocardia action. Methods Twelve mongrel dogs were randomly divided into two groups, control group and lidocaine group (n=6 in each group). Cardiopulmonary bypass (CPB) was routinely established. Cold crystalloid ST-Thomas Ⅱ cardioplegia was perfused routinely in control group. Single-dose LHKWBCP was injected in lidocaine group (5 ml/kg). Heart was arrested for 2 h and CPB assisted circulation for 30 min after releasing aortic crossclamp. Experiments were over 30 min after operation. Electrocardia action and hemodynamics were observed perioperatively. Results The time of inducing electromechanical diastolic arrest in lidocaine group was significantly shorter than that in control group (P<0.01). The time of electrocardiac consciousness in lidocaine group was significantly longer than that in control group (P<0.01). The rate of spontaneous heart resuscitation in lidocaine group was significantly higher than that in control group (P<0.01). Conclusion LHKWBCP significantly decreased the incidence of ventricular fibrillation after releasing aortic crossclamp