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温血高钾间断灌注心肌保护的临床应用
http://www.100md.com 《中国体外循环杂志》 2005年第2期
心肌保护,,体外循环;心肌保护;温血高钾;间断灌注,1资料与方法,2结果,3讨论,参考文献
     摘要:目的 探讨浅低温体外循环(CPB)温血间断灌注心肌保护的临床效果。方法 全组随机分为对照组(A组)68例,采用浅低温CPB温血高钾持续灌注心肌保护。实验组(B组)91例,采用浅低温CPB温血高钾间断灌注心肌保护。观察两组术中心肌保护效果的差别。结果 CPB时间、主动脉阻断时间B组明显小于A组(P<0.05);库血用量和24h胸腔引流量B组明显少于A组(P<0.05);主动脉开放前血钾浓度B组明显低于A组(P<0.05);主动脉开放后心脏自动复跳率B组明显高于A组(P<0.05);术后心功能临床观察两组无显著差异。结论 浅低温CPB温血高钾间断灌注保护心肌效果良好。

    关键词:体外循环;心肌保护;温血高钾;间断灌注

    The Clinical Use of High-Potassium Warm Blood Infusion to Protect Myocardium

    WANG Zhen-xiang,WU Li-li, QIAO Bin ,DUAN Hai-yun

    (Department of Cardiac Surgery 106 Hospital of Jinan Military Region,Shandong Jinan 250022 China)

    Abstract: OBJECTIVE To investigate the myocardial preservation effect of intermittent warm blood perfusion under low hypothermia CPB. METHODS Patients were randomly divided as follows: Control gronp comprised 68 cases with continuous warm hyperkalemia perfusion under low hypothermia CPB ; experimental group comprised 91 cases with intermittent warm hyperkalemia perfusion. Clinical effects were observed and compared the. RESULTS The CPB time and aortic arresting time of group B was clearly shorter than that of group A.The dosage of banked blood and drainge in 24 hours of group B was obviously less than that of group A.The pre-aortic-opening blood potassium concentration in group B was markedly lower than of group A. The post-aortic-opening auto-rebeating rate of group B was remarkblly higher than that of group A, After operation no remarkable differenc in the function of heart was found e in two groups. CONCLUSION The myocardial preservation effect of intermittent warm hyperkalemia perfusion under low hypothermia CPB is satisfactoly. ......

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