单次和多次冷晶体血灌注在未成熟心肌保护临床研究-外科学专业论文.docx

PAGE PAGE 1 单次和多次冷晶体血灌注在未成熟心肌保 护临床研究 中文摘要 目的：探讨单次灌注和多次灌注高钾冷晶体血停搏液对未成熟心 肌的保护作用。方法：60名先天性心脏病婴幼儿，随机抽样，分成单 次灌注高钾冷晶体血停搏液组（A组）和常规多次灌注冷晶体血停搏 液组（B组）,每组30名。于6个时点采颈静脉和冠脉血，检测心钠素 （ANP），降钙素基因相关钛（CGRP），内皮素(RT-1)和肌钙蛋白 (cTn-T)，心肌酶。分别在心内操作开始和结束时剪取小块右房组织， 电镜观察心肌超微结构结构变化。应用统计学分析实验结果，比较单 次灌注高钾冷晶体血停搏液和常规多次灌注高钾冷晶体血停搏液对 未成熟心肌的保护作用。结果：单次灌注高钾冷晶体血停搏液组（A 组）和常规多次灌注冷晶体血停搏液组（B组） 术后心钠素，降钙素 基因相关钛，内皮素，心肌酶均较术前增高，两组对比无统计学意义。 电镜下观察两组心肌超微结构破坏也无明显差异。结论：采用冷血停 跳液单次灌注,可达到与多次灌注同样的心肌保护效果。 关键词：单次和多次冷晶体血灌注；未成熟；心肌保护 Objective ： Investigate the single and multiple perfusion of cold crystalloid hyperkalemic blood cardioplegia on myocardial function in immature。 Method：random sampling 60 congenital heart disease infants into a single cold crystalloid perfusion high potassium blood cardioplegia group (A) and conventional perfusion repeatedly the blood of cold crystalloid cardioplegia group (B) (n = 30). Jugular vein and coronary blood collected at six point detection of atrial natriuretic peptide (ANP) and calcitonin gene-related titanium (CGRP), endothelin (RT-1) and troponin (cTn-T), cardiac enzymes. clipping a small piece of right atrial organizations at the start and end of surgery, electron microscopy of myocardial ultrastructure structure changes. The application of statistical analysis of experimental results to compare a single infusion high potassium cold crystalloid blood cardioplegia and the conventional perfusion repeatedly cold crystalloid hyperkalemic blood cardioplegia protective effect on immature myocardium. Result: Single crystal perfusion high potassium cold blood cardioplegia group (A) and the routine repeatedly perfusion blood of cold crystalloid cardioplegia group (B) postoperative atrial natriuretic peptide, calcitonin gene-related titanium, endothelin, serum creatine kinasecompared with preoperative increased compared two groups no significant difference. Electron microscopy of myocardial ultrastructure destruction also has no significant differences. Keywords: single and a n