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590例体外循环心脏直视手术心肌保护临床观察
引用本文:李兆志,梁景仁,屈根学,秦志端,王乃栋,侯立业. 590例体外循环心脏直视手术心肌保护临床观察[J]. 西安交通大学学报(医学版), 1990, 0(2)
作者姓名:李兆志  梁景仁  屈根学  秦志端  王乃栋  侯立业
作者单位:西安医科大学第一附属医院外科学教研室(李兆志,梁景仁,屈根学,秦志端,王乃栋),西安医科大学第一附属医院外科学教研室(侯立业)
摘    要:
体外循环心脏直视手术590例,用转流全身降温至24~27℃;应用4℃含钾停跳液灌注冠状动脉,每30min 1次;血液中度稀释(HCT20~25%、Hb80g/L);心脏冰屑局部降温至20~9℃等方法行心肌保护。结果使590例心脏均复苏成功,自动复跳413例(68%),除颤复跳177例(32%)。本法具有心肌降温充分、均匀,减少耗氧量,减少微栓等特点,致使心脏自动复跳率较高。

关 键 词:心肌保护  心脏直视手术  心脏复苏

A CLINICAL STUDY OF THE MYOCARDIAL PROTECTION IN 590 PATIENTS HAVING UNDERGONE OPEN HEART SURGERY WITH CARDIOPULMONARY BYPASS (CPB)
Li Zhaozhi,et al. A CLINICAL STUDY OF THE MYOCARDIAL PROTECTION IN 590 PATIENTS HAVING UNDERGONE OPEN HEART SURGERY WITH CARDIOPULMONARY BYPASS (CPB)[J]. Journal of Xi‘an Jiaotong University:Medical Sciences, 1990, 0(2)
Authors:Li Zhaozhi  et al
Affiliation:Li Zhaozhi,et al Department of Thoracic and Cardiovascular Surgery,First Affiliated Hospital)
Abstract:
The paper reports the myocaraial protection in 590 cases having undergone open heart surgery with CPB. The following methods were administered for heart preserving: Lowering the blood temperature to 24~27℃ under CPB; perfusing coronary arteries with cardioplegic solution(high potassium at 4℃) every half an hour; Keeping hemodilution at the middle degree(HCT: 20~25%, Hb: 80g/L); Lowering the temperature of the heart surface to 20~9℃ with snow ice. Automatic rebeating of the heart was in 413(68%) cases and defibrillative rebeating in 177(32%). Th method was characterized by complete hypo-temperature of the heart, decreaseing oxygen consumption and micro-thrombus etc. And therefore it made the automatic rebeating rate higher.
Keywords:myocardial protection  Open heart surgery  heart rebeating
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