左心辅助循环和完全体外循环下血细胞流变行为的对比实验研究

Comparative Experiment Study on Blood Cells Rheology of Left Heart Bypass and Cardiopulmonary Bypass

目的：研究左心辅助循环下微创冠状动脉旁路移植术（ＭＩＣＡＢＧ）血细胞流变行为的变化，并与体外循环下心脏手术后其相应的变化进行比较，以探讨其对减轻手术创伤的意义。 方法：６条犬经左前外小切口在左心辅助循环下，用同种颈动脉在降主动脉或乳内动脉与钝缘支间做旁路吻合（实验组）。６ 条犬在体外循环下建立冠心病的动物模型（对照组）。手术停机后取血，运用布氏显微镜行活血分析。 结果：左心辅助循环下ＭＩＣＡＢＧ术后血细胞流变学指标与术前相比无显著性变化。体外循环术后红细胞畸形率和白细胞活化率比术前显著增高，并显著高于ＭＩＣＡＢＧ术后的相应指标。 结论：左心辅助循环下的ＭＩＣＡＢＧ对血细胞流变行为没有明显的影响。与体外循环下心脏手术相比左心辅助循环的方法可以减轻手术创伤。

Objective:To compare the blood cells rheologic changes of minimally invasive coronary artery bypass grafting ( MICABG ) under left heart bypass,with corresponding variables in heart operations under cardiopulmonary bypass.To discuss the benefitial effects of MICABG. Methods:In six dogs a homogeneous carotid artery was anastomosed to the left internal mammary artery (LIMA) or the thoracic descending aorta through a small left anterior incision.And then a circumflex artery branch anastomosis was performed under left heart bypass.The mean bypass time was 92 5±19 9 minutes.In other six dogs,congenital heart disease or coronary artery disease animal models were built with cardiopulmonary bypass.The mean bypass time was 81 7±22 5 minutes.Live blood study was made for each animal at the end of bypass. Results:There was no blood rheologic change after MICABG under left heart bypass.Red blood cell malformation rate and white blood cell activation rate were significantly increased after the operations with cardiopulmonary bypass,and were significant higher than the corresponding variables after MICABG under left heart bypass. Conclusion:MICABG under left heart bypass has no disadvantageous effect on blood cells rheology,and is less traumatic than operations under cardiopulmonary bypass.