改良式温血停搏液在心脏瓣膜置换术中心肌保护作用的研究

Myocardial protection of modified warm blood cardioplegia

为探讨改良式温血停搏液 ( WBC)持续灌注在心脏瓣膜置换术中的心肌保护作用 ,随机将 10 3例患者分为两组 ,观察组 ( 43例 )术中采用 WBC、对照组 ( 60例 )应用冷晶体停搏液 ( CCC)行心肌保护。结果观察组血清心肌肌钙蛋白 T( c Tn T)水平明显低于对照组 ,随缺血时间延长差别更加明显 ;心脏自动复跳率明显高于对照组( P<0 .0 1)。观察组无死亡 ,对照组围术期死亡 2例 ,均为低心排。术后观察组多巴胺用量明显低于对照组( P<0 .0 1) ,补钾量明显减少。认为心脏瓣膜置换术中 WBC持续灌注较

The myocardial protection of modified warm blood cardioplgia(WBC) was studied prospectively for cardiac valve replacements.103 cases were divided into two groups randomly.The WBC was used for group WBC,the crystalloid cardioplegia(CCC) was used for control gruop.Result showed that the cTnT level in the blood of group WBC was lower obviously than that of group CCC,and the difference became much bigger with the prolongation of the myocardial ischemia;The ratio of the automatic heart rebeating in group WBC was much higher than that in group CCC(93% vs 46.7%,P<0.01);No perioperative death in group WBC,but 2 died of low cardiac output in group CCC.The dosage of Dopamin used postoperatively in group WBC was less obviously than that in group CCC(P<0.0l).The study suggests that the modified warm blood cardioplegia continuous perfusion method has better myocardial protection than that of crystalloid one for valve replacements.