Zhidkov I L, Kozhevnikov V A, Ivanov V A, Morozov Iu A, Andrianova M Iu, Van E Iu, Trekova N A
Anesteziol Reanimatol. 2006 Mar-Apr(2):13-8.
The efficiency of myocardial protection with cold crystalloid cardioplegia (CC) during operations on the heart under total ischemia and extracorporeal circulation was studied. Two hundred and fifty patients who underwent prosthetic or plastic repair of the aortic and mitral valves or plastic repair of the tricuspid valve were examined. Group 1 comprised 218 patients in whom the myocardium was protected with Konsol solution ("Biofarm "research-and-production enterprise, Russia); Group 2 included 32 patients in whom Custodiol solution ("Dr Franz Kohler Chemia GMBH", Germany). The volume of the Konsol solution required for CC was 400-2000 ml, with the duration of myocardial ischemia (MI) being 75 +/- 33 min; that of the Custodiol was 2000-4000 ml, with the duration of MI being 80 +/- 22 min. The used algorithm of administration of the solutions provided a persistent cardioplegic effect in both groups. After aortic declamping, there was a spontaneous recovery of cardiac performance in 84 and 40% in Groups 1 and 2, respectively. In the reperfusion period (RP), no significant differences were found in the basic hemodynamic parameters (heart rate, blood pressure, and central venous pressure) in both groups. After defect correction, cardiac output equally increased in both groups. The groups did not differ in the rate of inotropic support either. In RP, transient cardiac rhythm and conduction disturbances occurred in 19 and 28% in Groups 1 and 2, respectively.
研究了在完全缺血和体外循环下心脏手术中冷晶体心脏停搏液(CC)的心肌保护效果。对250例行主动脉瓣和二尖瓣置换或整形修复术或三尖瓣整形修复术的患者进行了检查。第1组包括218例用Konsol溶液(俄罗斯“Biofarm”科研生产企业)保护心肌的患者;第2组包括32例用Custodiol溶液(德国“Dr Franz Kohler Chemia GMBH”)保护心肌的患者。CC所需的Konsol溶液体积为400 - 2000 ml,心肌缺血(MI)持续时间为75±33分钟;Custodiol溶液体积为2000 - 4000 ml,MI持续时间为80±22分钟。所采用的溶液给药方案在两组中均产生了持久的心脏停搏效果。主动脉钳夹松开后,第1组和第2组分别有84%和40%的患者心脏功能自发恢复。在再灌注期(RP),两组的基本血流动力学参数(心率、血压和中心静脉压)无显著差异。缺损矫正后,两组的心输出量均同等增加。两组在使用正性肌力药物支持的比例上也无差异。在RP期,第1组和第2组分别有19%和28%的患者出现短暂的心律失常和传导障碍。