摘要
目的探讨温血诱导心停跳及终末温血灌注技术对婴幼儿心肌的保护作用。方法将３岁以下先天性心脏病儿４０例，随机分成温血诱导心停跳及终末温血灌注组（温血组）和冷晶体液停跳组（冷晶体液组）；两组主动脉阻断时间差异无显著性。体外循环前、后分别测定冠状静脉血丙二醛（ＭＤＡ）、超氧化物歧化酶（ＳＯＤ）、一氧化氮（ＮＯ）及内皮素（ＥＴ）含量；选取两组中法洛四联症（ＴＯＦ）患儿缺血后右心室心肌作超微结构对比研究。结果冷晶体液组ＭＤＡ（５．５±２．３）ｍｍｏｌ／Ｌ和ＥＴ（１６．４±６．３）ｎｇ／Ｌ升高值均高于温血组，分别为（１．１±０．５）ｍｍｏｌ／Ｌ及（６．８±２．８）ｎｇ／Ｌ（Ｐ＜０．０５），而ＳＯＤ升高值与ＮＯ下降值两组差异无显著性（Ｐ＞０．０５）。电镜观察缺血后超微结构，温血组优于冷晶体液组。结论温血诱导心停跳及终末温血灌注技术对婴幼儿心肌保护作用有利。
Objective To study the protective effect of warm induction and
reperfusion on young infants' myocardium. Methods Fourty children with congenital heart
disease(aged<3 years old) were randomly divided into two groups: group (warm induction and
reperfusion, n=20); group (cold crystalloid, n=20). There were no difference on the aortic
crossclamp time in the two groups, blood samples were taken from coronary sinus in
prebypass and postbypass to measure MDA, SOD, NO and ET. Postischemic ultrastructure of
TOF was observed in two groups. Results MDA (5.52.3) mmol/L,(1.10.5) mmol/L and ET(16.46.3)
ng/L, (6.82.8) ng/L released in group were higher than those in group (P<0.05), but there were
no significantly differences in SOD (26.09.2) mU/L, (27.310.0) mU/L, NO(19.99.7)mol/L,(18.49.4)
mol/L released (P>0.05). Myocardial ultrastructure appeared better preserved in group .
Conclusion The technique of warm induction and reperfusion has a good effect on openheart
surgery in young infants.
出处
《上海医学》
CAS
CSCD
北大核心
1999年第7期396-398,共3页
Shanghai Medical Journal
基金
国家自然科学基金
关键词
婴幼儿
心肌保护
温血诱导
终末再灌注
Young infants' myocardiumWarm
induction and reperfusion before clampingCold crystalloid cardioplegia
