Yuan S M, Zhu L B, Li G S, Liu M H, Dong C, Yu Y F, Wang D Q, Li J C, Luo J
Department of Cardiovascular Surgery, General Hospital of PLA, Beijing.
Chin Med J (Engl). 1994 Jul;107(7):515-20.
Twenty patients undergoing open-heart valvular operations were divided randomly into two groups. Intermittent perfusion of cold crystalloid (St. Thomas Hospital solution) with hypothermic cardiopulmonary bypass (CPB) in the hypothermic group and continuous administration of warm blood cardioplegia with normothermic CPB in the normothermic group were used respectively. The results of warm blood cardioplegia were superior to those of cold crystalloid. 70% of patients treated with the warm technique had spontaneous return of normal sinus rhythm shortly after removal of the aortic cross-clamp, compared with only 10% of the hypothermic group (P < 0.05). The extracorporeal support time from releasing of aortic clamp to the weaning of CPB was significantly shorter in the normothermic group (33.50 +/- 3.78 min vs. 25.00 +/- 4.64 min, P < 0.05). The postoperative ventilation support time was also much shorter than that of the hypothermic group (19.84 +/- 1.11 h vs. 38.98 +/- 16.55 h, P < 0.05). More atrial beating occurred in the normothermic group (80% vs. 20%, P < 0.05) during aortic clamping, and it is showed that continuous warm blood cardioplegia might not efficiently prevent the atrium from damage.
20例行心脏瓣膜开放手术的患者被随机分为两组。低温组采用低温体外循环（CPB）间歇性灌注冷晶体液（圣托马斯医院溶液），常温组采用常温CPB持续输注温血心脏停搏液。温血心脏停搏液的效果优于冷晶体液。采用温血技术治疗的患者中，70%在主动脉阻断钳移除后不久窦性心律自动恢复正常，而低温组仅为10%（P<0.05）。常温组从主动脉钳松开到CPB撤离的体外支持时间明显更短（33.50±3.78分钟对25.00±4.64分钟，P<0.05）。术后通气支持时间也比低温组短得多（19.84±1.11小时对38.98±16.55小时，P<0.05）。在主动脉阻断期间，常温组心房跳动更多（80%对20%，P<0.05），这表明持续温血心脏停搏液可能无法有效防止心房受损。
