碘气右束支活体染色的实验研究及临床应用

EXPERIMENTAL AND CLINICAL APPLICATION OF VITAL STAINING OF RIGHT BUNDLE BRANCH WITH IODINE GAS

为避免先天性心脏病矫治手术中传导系统的损伤,用自制碘蒸发装置于心脏手术中行碘气右束支活体染色。在离体和在体动物心脏右束支染色成功的基础上,临床应用16例,其中13例可清晰显示右束支,依此做传导束定位,用跨越右束支缝合法修补室缺,避免了房室传导阻滞和完全性右束支传导阻滞,并避免了室缺残余漏。用碘气行右束支活体染色,方法简便、安全,对预防复杂先天性心脏病矫治手术中传导系统的损伤,提高治疗效果具有重要意义。

Vital staining of the right bundle branch of the cardiac con- duction tissue with iodine gas was investigated for preventing postoperative complete heart-block and complete right bundle branch blook.After experi- ment on free canine heart,vital staining of the right bundle branch of canine heart was studied and no damage was found.Then,clinical applica- tion was done in 16 patients.Among them,15 were VSD and 1 was double outlet of right ventricle.In the 16 cases,the right bundle branch was stain- ed well and could be confirmed by the naked eye in 13 cases.According to the localization of the stained right bundle branch,the“cross”method of interrupted mattress sutures was used to repair the VSD.Complete heart-block and complete right bundle branch block were avoided without residual leakage of VSD.This method,therefore,was found to be valuable for preventing conduction disturbance during the operations of congenital cardiac defects.