摘要
心肌损伤是心脏手术引起的主要并发症之一。手术操作、全身炎性反应和心肌缺血-再灌注是造成心肌损伤的主要因素。轻柔而迅速的手术操作能减轻机械因素对心肌的损伤,缩短心肌缺血时间,从而减轻缺血-再灌注对心肌的损伤。良好的心肌保护效果是患者术后恢复的关键因素。近年来,通过调节心脏保护液的温度、成分、灌注方法而增加心肌氧供、降低氧耗、抑制炎性反应、清除氧自由基,并使用药物启动心肌细胞内源性保护机制,从而减轻心肌缺血-再灌注损伤,改善心肌保护效果。
Cardiac injury is a major complication of cardiac surgery. Surgical manipulation, systemic inflammatory response and cardiac ischemia/reperfusion injury （IRI） are main reasons of cardiac injury. Gentle and swift surgical manipu- lation can reduce mechanical myocardial injury, shorten myocardial ischemic time, and reduce myocardial IRI. Satisfactory myocardial protection plays a key role to improve postoperative recovery. In recent years, more and more myocardial protection strategies are employed to reduce myocardial IRI and improve myocardial protection, including modifications of temperature, composition and instillation approach of cardioplegia in order to increase myocardial oxygen supply, decrease myocardial oxygen consumption, inhibit inflammatory response and eliminate oxygen free radicals. Endogenous myocardial protection is also achieved by supplement of certain medications in cardioplegia.
出处
《中国胸心血管外科临床杂志》
CAS
2014年第5期681-685,共5页
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
基金
国家自然科学基金资助项目(81270324)~~
关键词
心肌保护
体外循环
心脏手术
Myocardial protection
Cardiopulmonary bypass
Cardiac surgery
