浅低温体外循环间断灌注的心肌保护效果观察

The clinical effect of intermittent warm blood perfusion under shallow hypothermia CPB for myocardial pretection

探讨浅低温体外循环温血间断灌注心肌保护的临床效果,提高瓣膜置换、冠脉搭桥手术的成功率。方法①浅低温体外循环温血高钾持续灌注心肌保护为对照组(A,n=53);②浅低温体外循环温血高钾间断灌注心肌保护为实验组(B,n=75)。观察两组临床结果并进行比较。结果体外循环时间、主动脉阻断时间B组明显少于A组;库血用量和24h胸腔引流量B组明显少于A组;主动脉开放前血钾浓度B组明显低于A组;主动脉开放后心脏自动复跳率B组明显高于A组。结论浅低温体外循环温血高钾间断灌注保护心肌效果显著,方法简单可行。

Objective To evaluate the myocardial pretection effect of intermittent warm blood perfusion under shallow hypothermia CPB in valve replacement and CABG.Methods(1)Group A comprised53cases with persistent warm blood(with hyper-kalium)perfusion under shallow hypothermia CPB as controlled group.(2)Group B comprised75cases with intermittent warm blood(with hyper-kalium)perfusion as experimental group.The clinical effect of two groups was observed and compared.Results The CPB time and aortic arresting clamping time of group B was clearly shorter than that of group A.The volume of banked blood and drainage from thoracic cavityin24hours of group B was obviously less than that of group A.The pre-opening-aortic blood kalium concentration of group B was markedly lower that of group A.The post-opening-aortic autorebeating rate of group B was remarkably higher than that of group A.Conclusion The myocardial pretection effect of intermittent warm blood(with hyper-kalium)perfusion under shallow hypothermia CPB is significant,and it is easy performed and feasible.