长时间心肌缺血心脏手术综合心肌保护的体会

Comprehensive Measures of Myocardial Protection for Long Time Myocardial Ischemia in open Heart Surgery

自1988年1月至1989年3月,施行复杂心脏手术心肌缺血时间在120～279(平均174)分钟的7例,包括Bentall手术2例,双瓣替换术4例,完全型房室共同通道1例。采用围手术期综合措施行心肌保护,获得良好效果,全组无死亡,无低心排血量及严重心律失常等并发症。作者认为,对复杂心脏手术病例采取综合心肌保护措施是必要的,我们所采用的方法,即使在使用鼓泡式氧合器情况下对心肌缺血持续3小时左右的心脏手术是安全有效的。

From January 1988 to March 1989, 7 cases of complicated open heart surgery (Bentall's operation 2, aortic and mitral double valves replacement 4, repair of A-V canal 1) were performed. The aortic cross-clamped time was 120～279 minutes (mean 174 min.). Comprehensive measures of myocardial protection were adopted in these cases. The results were satisfactory, without death and severe complications such as low cardiac output and serious arhythmias. Authors believe that comprehensive myocardial protection measures are necessary for those complicated heart surgery patients and the measures we have adopted are safe and effective for a relative long duration about 3 hours myocardial ischemia in open heart surgery with a bubble oxygnator.