低温室颤法心内直视手术的临床效果观察

Clinical effect of hypothermic ventricular fibrillation for open heart surgery

目的 观察与评价低温室颤法在心内直视手术中心肌保护的临床效果。方法 将 2 4例先天性心脏病病人随机分为冷心脏停搏液组 (n =13)和低温室颤组 (n =11) ,分别行心内直视畸形纠治术 ,观察心肺转流 (CPB)时间、辅助通气时间、心律失常发生率、多巴胺使用率、循环指标、血气分析指标、ICU恢复时间等指标。结果 冷心脏停搏液法的术中CPB时间、辅助通气时间、多巴胺使用量多于低温室颤组 ;心律失常率、循环指标、血气分析指标、ICU恢复时间等两组无差异。结论 低温室颤法不存在心肌缺血和缺血再灌注损伤 ,是一种可供选择的安全。

Objective To access the effect of using hypothermic ventricular fibrillation (HF) and hypotermic potassium cardioplegia (HC) for myocardial preservation in open heart surgery. Methods There were 24 patiens with cogenital heart disease ventricular septal defect (VSD). They were randomly divided into HF groups( n =11) and HC groups( n =13). The operative process and clinical outcomes were analysed. Results The time of cardiopulmonary bypass (CPB) and assisted ventilation were significantly shorter in group HF than in group HC ( P <0 05). The use of dopamine decreased in group HF ( P <0 05). No significant difference was identified postoperatively in the arrhythmia, hemoglobinuria, hemodynamic and metabolic variables and hours of ICU stay between groups HF and HC. Conclusion The method of HF supplies continually oxygen and blood to myocardium and avoids myocardial ischemia repurfusion injury in open heart surgery, so its effect on myocardial protection is better.