摘要
４２例复杂先心病矫正术中，以冷血停跳液（ＢＣＰ组）和晶体停跳液（ＣＣＰ组）灌注各２１例进行心肌高能磷酸盐、超微结构和临床观察比较研究，以观察冷血停跳液对心肌保护的作用及机制。结果显示：（１）开放主动脉再灌注１０分钟时，ＢＣＰ组ＡＴＰ、ＣＰ下降幅度是ＣＣＰ组的４８％和７５％；（２）电镜观察示ＢＣＰ组在细胞水肿、肌节挛缩及线粒体损伤等方面均较ＣＣＰ组轻；（３）ＢＣＰ组心搏恢复有力，心律规则平稳，对正性肌力药物需求减少。结果证明，在心肌缺血期间，ＢＣＰ能维持细胞正常代谢的需要，保证内环境的平稳，减少缺血心肌的损害，促进顿抑心肌的复原，在加强重危病人的心肌保护方面具有明显的优越性。ＢＣＰ心肌保护的效果优于ＣＣＰ。
The use of blood cardioplegic solution to improve myocardial protection was evaluated during cardiac operation on children with complex congenital heart diseases. Clinical data,high energy phosphate contents and ultrastructure of myocardium were monitored and investigated before and after cardiac arrest.21 pa tients received 15℃ blood cardioplegia (BCP)and 21patients 4℃ crystalloid cardioplegia(CCP).CCP group ATP and CP were 52% and 25% less than BCP group at 10 minutes of reperfusion respectively. Functional recovery of heart protected with BCP was generally better as compared to CCP.The requirement of positive inotropic support was less in BCP group.All the differences between two groups were highly significant(P<0.01).Degenerative ultrastructural signs(cytoplasmic edema,mycfibril contraction,mitochondrial swelling with disruption of cristae,etc)were frequently found in CCP group.There was only a moderate ischemic injury in BCP group. The results show BCPcan maintain metabolic balance and homeostasis of myocardium during ischemia. Myocardial injury was reduced and cardiac function recovered better after reperfusion.BCP used for myocardial protection can provide a better result in patient with complex congenital heart disease in all parameters than CCP.
出处
《中华胸心血管外科杂志》
CSCD
北大核心
1995年第6期333-335,共3页
Chinese Journal of Thoracic and Cardiovascular Surgery
关键词
晶体停跳液
先天性心脏病
冷血停跳液
矫正术
Cardioplegia
open heart surgery
Complex congenital heart disease
Myocardial injury
