摘要
目的评价浅低温心脏不停跳及中低温不阻断心肌血流室颤性停搏下心内直视手术的临床对比效果。方法将263例患者分为中低温室颤性停搏组(94例)及浅低温心脏不停跳组(169例),常规插管建立体外循环,转机后阻断上、下腔静脉并降温,不阻断升主动脉(如手术位于主动脉根部的成人患者,则阻断升主动脉并经冠状静脉窦持续逆行灌注),不使用心脏停搏液;鼻咽温度分别于浅低温心脏不停跳(32±1)℃、中低温室颤性停搏(26℃～27℃)下行心内直视手术。结果浅低温组手术死亡4例,中低温组死亡3例。两组术中转机时间、术后呼吸机辅助时间、强心药物的使用及心律失常的发生情况等差异无统计学意义。无一例发生空气栓塞。结论浅低温心脏不停跳及中低温室颤性停搏下心内直视手术都具有较好的心肌保护效果,但在中低温下手术更有利于心内的操作,对血液的保护效果更优,可推荐成为一种安全、可行的心肌保护方法。
Objective To summarize the clinical experience of mild hypothermic ventricular fibrillation in open heart surgery. Methods 263 patients underwent open heart surgery were divided into mild hypethermic [ 32±1 ）℃,n=169 ] and intermit hypothermic （26℃-27℃,n=94） group. Results 3 patients died pestoperation and the mortality is 2.1% in mild hypothermic ventficular fibrillation group. The time of cardiopulmonary bypass and assisted ventilation were shorter. Medicine necessary to support circulation is few. There was no serious arrhythmia and no air embolism. Conclusion Myocardial protection by mild hypothermic in open heart surgery is safe and effective in myocardial protection.
出处
《中国心血管病研究》
CAS
2005年第12期915-917,共3页
Chinese Journal of Cardiovascular Research
关键词
体外循环
心脏外科手术
体温调节
心肌保护
Extracorporcal circulation
Cardiac surgery procedurcs
Body temperature regulation
Myocardial pro tection
