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ID:9623633
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时间:2018-05-04
《血利钾心停搏液和双向灌注心肌保护的实验研究》由会员上传分享,免费在线阅读,更多相关内容在应用文档-天天文库。
1、血利钾心停搏液和双向灌注心肌保护的实验研究作者:章晓华,张镜方,吴若彬,肖学钧,陈萍【关键词】心停搏液摘要:目的 通过与三种经典心肌保护方法比较,探讨含血利多卡因高钾(血利钾)心停搏液和双向灌注心肌保护法的心肌保护作用。方法犬20只,随机分成四组(n=5),分别用晶体心停搏液(CG1)、冷稀释血心停搏液(CG2)、常温稀释血心停搏液(CG3)及血利钾心停搏液(EG)。每组均经历120min心脏缺血。观察心脏停搏情况、冠状静脉窦回流血量及心肌酶浓度、心肌细胞内钙离子(Ca2+)和丙二醛(MDA)及三磷酸腺苷(ATP)含量、心肌形态学改变。结果①
2、实验组(EG)心脏停搏时间短,心停搏液用量少,冠状静脉血流量及心肌氧摄取率在缺血前后无明显变化;②血清心肌酶水平各组间无显著差异;③EG再灌注心肌Ca2+超负荷及ATP含量下降较CG3明显,与CG2相似;④EG再灌注心肌MDA水平较CG1显著降低。⑤心肌形态学改变各组间无显著差异。结论 血利钾心停搏液和双向灌注具有确切的心肌保护作用。 关键词:缺血-再灌注损伤;心停搏液;心肌保护;体外循环 CardioprotectiveEffectsofLidocaine-Hyperpotassium-BloodCardioplegicSolution
3、ia-ReperfusionInjuryinCanineHearts Abstract:OBJECTIVEToinvestigatethemyocardialprotectiveeffectsoflidocaine-hyperpotassium-bloodcardioplegicsolutionostyocardialprotection.METHODS20adultcaninesonarybypass(CPB)andrandomizedtorecEivefourmyocardialprotectiveprotocolsrespective
4、ly(5ineachgroup):coldsupplementingSt.ThomasHospitalcrystalloidsolutioncardioplegiaantegradelyandintermittently(CG1),hypothermicbloodcardioplegiaantegradelyandintermittently(CG2),bloodcardioplegiaantegradelyandcontinuously(CG3),andlidocaine-hyperpotassium-bloodcardioplegiait
5、tedto120minutesofmyocardialischemiaanda30minutesperiodofreperfusion.Arrestoftheheartandcoronaryvenoussinusflocardiacenzymesandmyocardialintracellularmalondiadehyde(MDA),ioncalcium(Ca2+),adenosinetriphosphate(ATP)easured.Myocardialstructurechangesafterischemiaandreperfusioni
6、croscope.RESULTSLidocaine-hyperpotassium-bloodcardioplegicsolutioneofarrestoftheheart,anddecreasedthevolumeofcystalloidcardioplegicsolutionused.Thereyocardialretrievaloxygen(MRO)betiainallgroups.TherecardiacenzymesafterischemiaparingEGilartoCG2.Thelevelofmyocardialintracell
7、uarMDAafter30minutesreperfusioninEG-bloodcardioplegicsolutionandbineddeliveryroutesrepresentsasimple,safeandeffectivemethodofmyocardialprotectionaybeanalternativetotraditionalcardioprotectivetechniques. Keyia-reperfusioninjury;cardioplegicsolution;myocardialprotection;card
8、iopulmonarybypass 心停搏液的成分、灌注方式及不同心肌保护方法的选用等仍存在争议[1-3]。含血利多卡因高钾心停搏液(简称血利钾心停搏液)及双向性
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