婴幼儿温-冷-温停博液灌注心肌的临床研究

Clinical Study of Warm-Cold-Warm Perfusion on Myocardial Protection

目的 观察 32℃新鲜氧合血行温血诱导停搏和终末温血再灌注对心肌保护的影响。方法 婴幼儿法洛四联症根治术 6 4例 ,随机分为 :温血组 32例 (温血诱导停搏后改用冷血灌注 +终末温血灌注 ) ;冷血组 32例 (冷晶体诱导停搏后改用冷血灌注 )。分别观察主动脉开放后心脏复跳和最初心律。结果 温血组全部自动复跳 ;冷血组自动复跳率为 71.88% (P <0 .0 5 ) ,且最初心律失常率 2 8.12 % (P <0 .0 5 )。

OBJECTIVE To study the effect of warm-blood induced cardiac arrest and end perfusion with 32°C fresh oxygenated blood .METHODS 64 infants undergoing radical correction of Tetralogy of Fallot were randomly classified into 2 groups:warm group and cool group, with 32 infants in each group. In the warm group,cardiac arrest was induced with warm-blood cardioplegia,and then, the hearts were perfused with cool blood. Before removing the X-clamp, warm blood was again used for the last infusion.In the cool group,by contrast cold crystalloid cardioplegia was used to induce cardiac arrest with no and on final warm blood infusion. The incidence of defibrillation and occurrence of arrhythmia wsa recorded after off-clamps. RESULTS Defibrillation was not necessary in the warm group,and the incidence of defibrillation in the cool group was 28.12%(P<0.05); In the warm group, all infants resumed their sinus rhythm, while the incidence of ventricular or supraventricular arrhythmia was 28.12%(P<0.05)in the cool group. CONCLUSION Warm-blood induced cardiac arrest with a final infusion of warm blood was advantageous for myocardial protection in cardiac surgery.