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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(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(2).
Authors:Li Zhaozhi  
Institution: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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