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目的探讨温血诱导心停跳及终末温血灌注技术对婴幼儿心肌的保护作用。方法将３岁以下先天性心脏病儿４０例，随机分成温血诱导心停跳及终末温血灌注组（温血组）和冷晶体液停跳组（冷晶体液组）；两组主动脉阻断时间差异无显著性。体外循环前、后分别测定冠状静脉血丙二醛（ＭＤＡ）、超氧化物歧化酶（ＳＯＤ）、一氧化氮（ＮＯ）及内皮素（ＥＴ）含量；选取两组中法洛四联症（ＴＯＦ）患儿缺血后右心室心肌作超微结构对比研究。结果冷晶体液组ＭＤＡ（５．５±２．３）ｍｍｏｌ／Ｌ和ＥＴ（１６．４±６．３）ｎｇ／Ｌ升高值均高于温血组，分别为（１．１±０．５）ｍｍｏｌ／Ｌ及（６．８±２．８）ｎｇ／Ｌ（Ｐ＜０．０５），而ＳＯＤ升高值与ＮＯ下降值两组差异无显著性（Ｐ＞０．０５）。电镜观察缺血后超微结构，温血组优于冷晶体液组。结论温血诱导心停跳及终末温血灌注技术对婴幼儿心肌保护作用有利。
Objective To investigate the protective effects of warm-blooded cardioplegia and terminal warm-blooded infusion on infants and young children’s myocardium. Methods Forty children with congenital heart disease under 3 years of age were randomly divided into warm-heart-induced cardioplegia and terminal warm-blooded group (warm-blooded group) and cold-blooded group (cold crystalloid group) There was no significant difference in arterial occlusion time. Before and after cardiopulmonary bypass, the content of malondialdehyde (MDA), superoxide dismutase (SOD), nitric oxide (NO) and endothelin (ET) TOF) in children with ischemic right ventricular myocardial ultrastructure comparison study. Results The elevated values of MDA (5.5 ± 2.3) mmol / L and ET (16.4 ± 6.3) ng / L in the cold crystalloid group were significantly higher than those in the warm group (1.1 ± 0 .5 mmol / L and 6.8 ± 2.8 ng / L respectively (P <0.05), while there was no significant difference between the two groups (P> 0.05). Electron microscopy of ischemic ultrastructure, warm blood group was better than cold crystal fluid group. Conclusions The warm-heart-induced cardiac arrest and terminal warm-blooded infusion are beneficial to myocardial protection in infants.