控制性再灌注防治心肌缺血再灌损伤的实验及临床研究

The Experimental Study and Clinical Application of Controlled Reperfusion on Prevention and Treatment of Myocardial Ischemic Reperfusion Injury

控制性再灌注(简称控灌)具有降低心肌再灌损伤,保护心肌的优良作用,应用自体温氧合血停跳液行控制性再灌注,经106例及采用本法前105例比较结果显示:该法自动复跳率高,术后循环恢复满意,极少应用升压药支持,几乎无严重心律失常,死亡率明显降低。动物实验证实:复跳后实验组心功能明显优于对照组,超微结构破坏轻微。本文对控灌防治心肌缺血再灌注损伤的机理进行了探讨,提出控灌条件及措施。

Controlled reperfusion (CR) has the effect on reducing myocardial reperfusiln injury andprotecting myoeardium. Using warm oxygenated auto blood cardioplegia as con- trolled reperfusion,the results of 106 eases compared with that of 105 cases without controlled reperfusion:The former has higher rate of spontaneus resumption of heart beat more satisfactory postoperative circulatory functions,with mini- mal need of inotropic drug.few serious arrhythmia,and less operative mortality rate.The experimental study on dogs showed that cardiac functions after the heart beat recovered were significantly better in CR group than that in without controlled group,and the ultrsatructures of myoeardium were better preserved.In this paper,the mechanisms of CR on prevention and treatment of myocardial ischemic reper- fusiln injury were discussed,and factors,measures of con- trolled reperfusion are proposed.