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[心脏手术中心肌保护的一般特征]

[General features of myocardial protection in heart surgery].

作者信息

González Vergara B

机构信息

Servicio de Perfusión, Instituto Nacional de Cardiología Ignacio Chávez, INCICH, Juan Badiano No. 1, 14080 México, D.F.

出版信息

Arch Cardiol Mex. 2001 Jan-Mar;71 Suppl 1:S201-7.

Abstract

Cardioplegia solutions commonly used in cardiac surgery, without doubt, have decreased the damage to the myocardium during these procedures; nonetheless, optimal cardioplegia composition is still under investigation, one of the most important factors to date is the use of hypothermia. Intermittent cold cardioplegia has been adopted as the choice for myocardial protection by surgeons. An alternative method, based on the principles of electromechanic asystole and normothermic aerobic perfusion, is the use of blood cardioplegia. As Follete et al. demonstrated, blood cardioplegia protects more than asanguineous cardioplegia, this conclusion is based on abnormal electrocardiographic tracings and enzyme activity in the postoperative period when both methods are compared. In this review we make a brief introduction on the physiologic and ischemic conditions of the myocardial cell, as well as on the principles of myocardial protection and techniques designed to avoid ischemic damage.

摘要

毫无疑问,心脏手术中常用的心脏停搏液减少了这些手术过程中心肌的损伤;尽管如此,最佳的心脏停搏液成分仍在研究中,迄今为止最重要的因素之一是低温的使用。间歇性冷心脏停搏已被外科医生用作心肌保护的选择。一种基于机电性心搏停止和常温有氧灌注原理的替代方法是使用血液心脏停搏液。正如福莱特等人所证明的,与无血心脏停搏液相比,血液心脏停搏液能提供更好的保护,这一结论是基于两种方法比较时术后异常心电图描记和酶活性得出的。在这篇综述中,我们简要介绍心肌细胞的生理和缺血状况,以及心肌保护的原则和旨在避免缺血损伤的技术。

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