氧合温血心麻液持续灌注对心肌超微结构的影响及临床结果分析

The effect of warm oxygenated blood cardioplegia continuous perfusion coronary artery on myocardial ultrastructurc and clinical result analysis

我们对10例体外循环手术病例采用氧合温血心麻液持续灌注心脏停跳,观察其对心肌超微结构的影响并分析了临床结果。电镜结果表明采用氧合温血持续灌注可保持心肌超微结构正常,镜下线粒体排列整齐,线粒体内、外膜清晰可辨,未见明显线粒体肿胀及空泡现象,肌原纤维走向规则,明暗带规整.未发现肌纤维断裂液化现象,细胞核染色质均勺,核膜清楚,未发现肌浆网扩张现象。所有病例均自动复跳,空跳时间明显缩短,复跳后心功能良好,术后血流动力学恢复满意,无任何并发症。本实验说明持续灌注氧合心麻液是一种安全、有效的心肌保护方法,可避免心脏冷损伤及缺血心肌再灌注损伤。

We have observed the effect of oxygenated warm biood cardiopiegia induction heart ar- rest on myocardoal ultrastructure and analysed clinical result in ten patients who suffered from extra- corporal circulatio operation.Electron microscope result shows: Oxygented warm blood cardioplegia continuous perfusion coronary artery may protect protect the ultrastracture of myocardium,it show- that mitochondria arrange keeps in good order,mitochondria is swollen and hydropic, the membrane of mitochondria is clear.Myofibril keeps in good order.Myofidril is not break off and liquid.Nucleus and chromatin is normal.Endoplasmic reticulum is not dilatation.After operation ten patients recover nor- mal sinus ryhthm.Time of empty beating is very short,cardiac function is very good.There is not an complication. The study shows that continuous oxygenated warm blood cardioplegia perfusion coronary artery is a safty,effective method,which can prevent clod injury and ischemic reperfusion damage.