体外循环心脏手术中心肌保护方法的改进

Improvement of Myocardial Protection in Heart Surgery

采用充氧温血停跳液经主动脉根部间断灌注，或经冠状静脉窦持续逆行灌注，应用26例。其中单瓣置换8例，双瓣置换4例，主动脉窦瘤破裂修补2例，左房粘液瘤切除5例，心功能Ⅲ～Ⅳ级者22例。对照观察发现，充氧温血灌注法术中心脏自动复跳率高，术后循环功能稳定，严重心律失常及低心排综合征发生率低，对缺血心肌的保护优于冷晶体灌注法。

This report introduces an improved myocardial protection method in heart surgery, that perfusion of warm oxygenated blood through the aortic root or retrograde per fusion through coronary sinus instead of the former method of using cooling crystalloid solution was adopted. The method has been used in 26 risky cases including MVR 8, DVR 4, Repair of Valsalva Aneurysm 2, Resection of Cardiac Myxoma 5, etc. Among them 22 cases(around 88%) functionally belonged to Class Ⅲ-Ⅳ. We observed that the advantages of the improved method lie in the high rate of spontaneous return of rhythm and low occurance of low output syndrome and fatal arrhythmia.