_心肌缺血的病理生理与心肌保护.pdf

201410215 Chin J Clin Thorac Cardiovasc Surg October 2014 Vol. 21 No. 5 • 681 • 610041 - - - R654.1 A 1007-4848201405-0681-05 DOI 10.7507/1007-4848 Pathophysiology of Myocardial Ischemia and Myocardial Protection during Cardiac Surgery XIAO Qian-hui XIONG Ji-yue QIN ZhenDU Lei.Department of Anesthesiology West China HospitalSichuan UniversityChengdu 610041P. R. China Corresponding authorDU Lei Emailqq. com Abstract Cardiac injury is a major complication of cardiac surgery. Surgical manipulationsystemic infl ammatory response and cardiac ischemia/reperfusion injuryIRI are main reasons of cardiac injury. Gentle and swift surgical manipu- lation can reduce mechanical myocardial injuryshorten myocardial ischemic timeand reduce myocardial IRI. Satisfactory myocardial protection plays a key role to improve postoperative recovery. In recent yearsmore and more myocardial protection strategies are employed to reduce myocardial IRI and improve myocardial protectionincluding modifi cations of temperaturecomposition and instillation approach of cardioplegia in order to increase myocardial oxygen supplydecrease myocardial oxygen consumptioninhibit infl ammatory response and eliminate oxygen free radicals. Endogenous myocardial protection is also achieved by supplement of certain medications in cardioplegia. Key words Myocardial protection Cardiopulmonary bypass Cardiac surgery Foundation item National Natural Science Foundation of Chin