冷温氧合血停搏液联合灌注对心肌保护作用的实验研究

Experimental study of protection effect of cold and warm crystalloid cardioplegia on myocardium

目的 :观察不同灌注方法改善心肌的保护效果。方法 :用家猪 16头 ,随机分为两组 :Ⅰ组用冷氧合血停搏液间断灌注 ,Ⅱ组在Ⅰ组的基础上加用温氧合血停搏液诱导停搏及复苏再灌注。于体外循环下心肌缺血再灌注期间 ,观察心肌电机械活动、转流前后左心功能、心肌ATP、心肌含水量及超微结构的变化。结果 :Ⅱ组复苏后血流动力学的稳定性、左心功能的恢复优于Ⅰ组 ,心肌ATP及心肌的含水量的损害明显低于Ⅰ组。结论

Objective To observe the protective effect of different methods to promote myocardium. Methods 16 pigs were divided into two groups: group Ⅰ received cold oxygenated blood cardoplegia infusion and group Ⅱ received warm oxygenated blood cardoplegia multiple infusion based on group Ⅰ. Cold blood cardioplegia was used throughout CPB in group Ⅰ, but group Ⅱ was given cold blood cardioplegia, followed by warm blood cardioplegia immediately after aortic clamping and just before aortic unclamping. Myocardial electromechanial motion, contents of myocardial adenosine triphosphate and warter, ultrastructure changes and left ventricular function were observed during the the ischemia and reperfusional period. Results Hemodynamic stability and left ventricular function in group Ⅱ were better significantly than those in groupⅠ, damage of contents of myocardial adenosine triphosphate and warter in group Ⅱ were lower remarkably than those in groupⅠ. Conclusions It suggested that united-infusion of cold and warm blood cardioplegia could effectively protect the myocardium.