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心肌保护中我们需要低温吗?

Do we need hypothermia in myocardial protection?

作者信息

Yamamoto F

机构信息

Department of Cardiovascular Surgery, Akita University School of Medicine, 1-1-1 Hondo, Akita 010-8543, Japan.

出版信息

Ann Thorac Cardiovasc Surg. 2000 Aug;6(4):216-23.

Abstract

BACKGROUND

Since the concept of "elective cardiac arrest" has been introduced by Melrose et al., rapid arrest, hypothermia and additional protection has been employed in surgical myocardial protection in clinical and experimental settings. And cardioplegia technique employed these components improved clinical results of open heart surgery except special cases which require longer cardiac arrest. In 1991, Salemo et al. offered striking impact on most of cardiac surgeon with the report of retrograde continuous warm blood cardioplegia. Since then several reports pointed out the benefit of warm blood cardioplegia although inherent disadvantage of continuous cardioplegia were the inadequate visualization of the operative field. These reports recently lead some cardiac surgeon to intermittent warm blood cardioplegia.

METHODS

This review introduced and examined our experimental and clinical data with reference to establish new surgical myocardial protection.

CONCLUSIONS

Experimental and clinical data might encourage us to employ intermittent tepid (29 ) blood cardioplegia as a practical cardioplegia in open heart surgery.

摘要

背景

自梅尔罗斯等人提出“选择性心脏骤停”的概念以来,快速心脏骤停、低温及额外保护措施已被应用于临床和实验环境下的手术心肌保护。并且采用这些要素的心脏停搏技术改善了心脏直视手术的临床效果,但特殊情况需要更长时间心脏骤停的除外。1991年,萨莱莫等人关于逆行持续温血心脏停搏的报告给大多数心脏外科医生带来了巨大冲击。从那时起,尽管持续心脏停搏存在手术视野可视化不足这一固有缺点,但仍有几份报告指出了温血心脏停搏的益处。这些报告最近促使一些心脏外科医生采用间歇性温血心脏停搏。

方法

本综述引入并审视了我们的实验和临床数据,以参考建立新的手术心肌保护方法。

结论

实验和临床数据可能促使我们在心脏直视手术中采用间歇性微温(29℃)血液心脏停搏作为一种实用的心脏停搏方法。

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