新型持续低温心肌灌注体外循环不降温模式的应用研究

Continuous hypothermic myocardial perfusion during cardiopulmonary bypass without cooling down in congenital heart disease surgery

目的探讨心脏持续低温灌注体外循环(CPB)不降温在先天性心脏病患者手术中的应用价值。方法将101例先天性心脏病患者随机分为两组,常温组46例,低温组55例。对比两组CPB时间、主动脉阻断时间、手术时间、术后血尿、乳酸水平、使用多巴胺时间等检测指标间的差别。结果常温组CPB时间、手术时间均比低温组短(P<0.05),术后引流量、使用多巴胺时间、血尿发生率、乳酸水平均较低温组低(P<0.05)。结论心脏持续低温灌注CPB不降温方法用于先天性心脏病矫治手术,可明显缩短手术时间,心肌保护良好,提高手术成功率。

Objective To explore the value of continuous hypothermic perfusion during cardiopulmonary bypass（ CPB） without cooling down in congenital heart disease surgery. Methods One hundred and one patients underwent heart surgery were randomly divided into two groups,with 46 cases in normothermia group and 55 cases in hypothermia group. CPB time,aortic clamping time,operation time,hematuria,postoperative drainage,use of dopamine and lactate levels were compared between the two groups. Results CPB time and operation time in normothermia group were lower than those in hypothermia group（ P 0.05）,postoperative drainage,the amount of dopamine,lactate levels and hematuria were also lower than those in hypothermia group（ P 0.05）. Conclusion Hypothermic myocardial perfusion during cardiopulmonary bypass without cooling down in the application of congenital heart disease surgery can shorten the operation time significantly and shows effects of myocardial protection,as well as improving the surgical success rates.