摘要
目的探讨温血诱导心脏停搏及终末温血灌注技术在婴幼儿先天性心脏病（ＣＨＤ）手术中对心肌的保护作用。方法将４０例＜３岁ＣＨＤ患儿随机分成２组：温血诱导心脏停搏＋终末温血灌注组（温血组）；冷晶体液心脏停搏组（冷晶体组）。２组主动脉阻断时间无明显差异；体外循环前、后分别抽血测定乳酸脱氢酶（ＬＤＨ）、肌酸激酶（ＣＫ）、肌钙蛋白Ｔ（ＴｎＴ）；电子显微镜观察两组缺血后心肌超微结构。结果发现冷晶体组ＬＤＨ（１９７．９±７３．６Ｕ／Ｌ），ＣＫ（１０７．６±５０．６Ｕ／Ｌ），ＴｎＴ（８．９±４．０μｇ／Ｌ）升高值均高于温血组（８５．２±４７．７Ｕ／Ｌ，５５．８±３５．９Ｕ／Ｌ和３．３±２．４μｇ／Ｌ，Ｐ＜０．０５），电子显微镜观察缺血后超微结构温血组优于冷晶体组。
Objective To study the protective effect of warm induction and reperfusion on young infant myocardium. Methods Fourty children with congenital heart diseases(aged<3 years old) were randomly divided into two groups: Group of warm blood (warm induction and reperfusion blood cardioplegia, n=20); Group of cold crystalloid(n=20). There were no difference of the aortic crossclamp time in two groups, 10ml blood was took from coronary sinus in pre bypass and post bypass time to measure lactat dehydrogenase(LDH),creatine kinase(CK),troponin T(TnT). Postischemic ultrastracture of TOF was observed in two groups. Results LDH(197 9±73 6U/L,85 2±47 7U/L),CK(107 6±50 6U/L,55 8±35 9U/L),TnT(8.9±4.0μg/L,3.3±2.4μg/L) release in group of cold crystalloid were higher than those in warm boold group ( P < 0 05),myocardial ultrastracture was more excellent in group of warm blood than group of cold crystalloid . Conclusion The technique of warm induction and reperfusion has a good effect on open heart surgery in young infants.
出处
《中国胸心血管外科临床杂志》
CAS
1999年第1期1-3,共3页
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
基金
国家自然科学基金
关键词
婴幼儿
心肌保护
温血诱导停搏
心脏外科手术
Young infant myocardium
Myocardial preservation
Warm induction
Warm reperfusion before clamp releasing
