| 摘要: |
| 目的:对比观察间断灌注冷血、持续灌注冷血及持续灌注温血心脏停搏液对长时间停搏心脏心室功能的保护作用。方法:利用猫体外循环模型,分别用间断冷血、持续冷血及持续温血停搏液保护心肌,测定其心功能、心肌酶释放及丙二醛(MDA)含量变化。结果:心脏停搏180 min复灌60 min时,间断冷血及持续冷血停搏液灌注组心室功能明显下降,心肌酶释放及MDA含量增加,尤以前者为甚,而持续温血停搏液灌注组心室功能在复灌后其测值接近停搏前水平,心肌酶释放及MDA含量亦出现类似变化。结论:持续灌注温血心脏停搏液在心脏长时间的停搏过程中可提供充足的血供,是一种理想的心肌保护方法,特别适用于需长时间停搏及高危心脏病患者的术中心肌保护。 |
| 关键词: 心肌保护、体外循环、温血停搏液 |
| DOI： |
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| 基金项目: |
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| The effects of three different myocardial protective methods on the recovery of cardiac performance after long time cardiac arrest |
| 陈克明,杨玲,张宝仁,胡寿鹏,陈龙 |
| () |
| Abstract: |
| Objective:To compare the effects of intermittent cold blood cardioplegin, continuous cold blood cardioplegin and continuous warm blood cardioplegin on the recovery of cardiac performance using the cat cardiopulmonary bypass, after longtime cardiac arrest. Methods:twenty-four cats weighting 3-3.5 kg were divided at random into 4 groups. Hearts in group Ⅰ were not subjected to ischemic arrest, hearts in group Ⅱprotected with intermittent cold blood cardioplegia, hearts in group Ⅲ with continuous cold blood cardioplegia, hearts in group Ⅳ with continuous warm blood cardioplegia. After 180 min cardiac arrest, all hearts were reperfused for 60 min. Results:the cardiac perfomance was significantly reduced in group Ⅱ and Ⅲ, especially in group Ⅱ protected with intermittent cold blood cardioplegia, and kept almost normal in group Ⅳ with continuous warm blood cardioplegia. LDH-1 and MDA content rose to a higher level in group Ⅱ and Ⅲ after reperfusion, but almost normal in group Ⅳ protected with continuous warm blood cardioplegia. Conclusion: Our data indicate that the method of continuous warm blood cardioplegia is safe and effective and represents a new conceptual approach to maintaining excellent myocardial preservation during cardiac arrest. It can enhance the recovery of cardiac performance after reperfusion |
| Key words: myocardial protection extracorporeal circulation warm blood cardioplgeia |
