温氧合血心停搏液微流量连灌心肌超微结构的临床研究
温氧合血心停搏液,,温氧合血心停搏液；高流量；微流量；心肌超微结构,1资料与方法,2结果,3讨论,【参考文献】
【摘要】 目的 评估温氧合血心停搏液不同流量连灌对心肌的保护作用。方法 我们选择60例择期心脏手术患者分别用温氧合血心停搏液微流量连灌[A组0.5ml/(kg·min)],高流量连灌[B组2.0ml/(kg·min)]灌注的结果进行分析。结果 电子纤维镜观察两组在主动脉阻断前，心肌超微结构基本正常，阻断60min，两组均出现线粒体肿胀，基质密度下降，糖原减少，部分肌原纤维松弛，复跳后30min，两组线粒体肿胀减轻，糖原大体恢复正常，组间差异无显著性。临床结果表明，两组术后需循环和呼吸辅助时间短，心功能恢复迅速，稳定。结论 微流量氧合血心停搏液连续灌注亦能保持心肌能量储备，保护心肌超微结构完整，术后心功能恢复迅速。【关键词】 温氧合血心停搏液；高流量；微流量；心肌超微结构
Clinical study of ultrastructures of the myocardium on warm oxygenated blood cardioplegia at minimum-flow continuous perfusion
LIU Ning.
Cardiothoracic Surgery Department,The First Peoples Hospital of Shangqiu,Shangqiu 476100,China
【Abstract】 Objective To investigate the effects of different flow volume of continuous warm oxygenated blood cardioplegia on open heart surgery.Methods A prospective,randomized study was performed on 60 patients undergoing value replacement and congenital heart disease with myocardial protection by minimum flow perfusion(0.5ml/kg·min-1,n=30),highflow perfusion(2.0ml/kg·min-1,n=30),cardioplegia,preoperative and surgical characteristics of the two groups were similar.Results Ultrastructure of the myocardium were not significantly different between two groups before the aortic cross-clamping.Myofibrils were loose apparently and its crest was in disorder with the decrease of density,matrix focal dissolved of the crest,glyeco gen decreased mitochondrial membrance swelling between two groups when the crossclamped time was 60 minutes.Ultrastructure of myocardium was almost normal after 30 minutes reperfusion.Conclusion Minimum-flow continuous perfusion of warm blood cardioplegia appeared to be superior in safety,protecting the myocardial ultrastructure. ......
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