590例体外循环心脏直视手术心肌保护临床观察

A CLINICAL STUDY OF THE MYOCARDIAL PROTECTION IN 590 PATIENTS HAVING UNDERGONE OPEN HEART SURGERY WITH CARDIOPULMONARY BYPASS (CPB)

体外循环心脏直视手术590例,用转流全身降温至24～27℃;应用4℃含钾停跳液灌注冠状动脉,每30min 1次;血液中度稀释(HCT20～25%、Hb80g/L);心脏冰屑局部降温至20～9℃等方法行心肌保护。结果使590例心脏均复苏成功,自动复跳413例(68%),除颤复跳177例(32%)。本法具有心肌降温充分、均匀,减少耗氧量,减少微栓等特点,致使心脏自动复跳率较高。

The paper reports the myocaraial protection in 590 cases having undergone open heart surgery with CPB. The following methods were administered for heart preserving: Lowering the blood temperature to 24～27℃ under CPB; perfusing coronary arteries with cardioplegic solution(high potassium at 4℃) every half an hour; Keeping hemodilution at the middle degree(HCT: 20～25%, Hb: 80g/L); Lowering the temperature of the heart surface to 20～9℃ with snow ice. Automatic rebeating of the heart was in 413(68%) cases and defibrillative rebeating in 177(32%). Th method was characterized by complete hypo-temperature of the heart, decreaseing oxygen consumption and micro-thrombus etc. And therefore it made the automatic rebeating rate higher.