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目的 评价4℃氧合血停搏液在婴幼儿先天性心脏病 (简称先心病 )手术中的心肌保护效果。 方法 选择病情偏重的先心病手术婴幼儿52例 ,采用4℃氧合血停搏液方法 (A组 ) ,并与同期应用传统冷晶体停搏液的先心病手术婴幼儿67例 (B组 )进行比较。A组在主动脉阻断后先泵入4∶1高钾氧合冷血停搏液 ,心脏停跳后 ,再以4∶1低钾氧合冷血停搏液持续灌注维持。B组在主动脉阻断后先灌注4℃晶体停搏液15ml/kg,然后每20min重复半量。 结果 两组心脏自动复跳率、主动脉开放后室颤发生率、磷酸肌酸激酶同工酶的差别均有显著性意义 (P<0.05或0.01)。结论 在婴幼儿先心病手术中4℃氧合血停搏液优于传统的冷晶体停搏液。开放主动脉前用温血灌注 ,心脏自动复跳率高。加强监测、结合使用超滤可消除高钾血症
Objective To evaluate the myocardial protective effect of 4 ℃ oxygenated blood cardioplegia in infants with congenital heart disease (CHD). Methods Fifty-two infants with congenital heart disease undergoing surgery were enrolled in this study. Group A (4 ℃ oxygenated cardioplegia) and 67 infants (group B) with congenital heart disease treated with traditional cold crystalloid cardioplegia Compare. In group A, 4: 1 hyperkalemic cardioplegia was first pumped into the aorta, and then the heart was stopped. Then, 4: 1 hypokalemic cold cardioplegia solution was continuously infused. In group B, 15ml / kg of crystalloid cardioplegia at 4 ° C was perfused first after the aorta was blocked, and then half of the dose was repeated every 20 minutes. Results The heart rate of spontaneous rebound, the incidence of ventricular fibrillation after aortic opening and the creatine phosphokinase isoenzymes in both groups were significantly different (P <0.05 or 0.01). Conclusions 4 ° C oxygenated cardioplegic solution is superior to traditional cold crystalloid cardioplegia in infants with congenital heart disease. Open the aorta with warm blood perfusion, the heart automatically rebound rate. Strengthen the monitoring, combined with the use of ultrafiltration can eliminate hyperkalemia