Yamazaki I, Yano Y, Kondo J, Matsumoto A, Kurata H, Soma T
First Department of Surgery, Yokohama City University School of Medicine, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1996 Apr;44(4):467-71.
Intermittent retrograde cold blood cardioplegia was compared with retrograde crystalloid cardioplegia. Twenty-two adult patients underwent open heart surgery divided into two groups. Group BCP (n = 10) was protected with 15 degrees C blood containing potassium 15 mEq/l; Group CCP (n = 12) was protected with 4 degrees C St. Thomas' Hospital cardioplegic solution. Lactate, pyruvate, and CK-MB levels in coronary sinus blood were measured at 5 and 15 minutes after aortic unclamping and 5 minutes after weaning from cardiopulmonary bypass (CPB) in both groups. CPB time, cross-cross clamp time, incidence of postoperative low output syndrome and spontaneous return to sinus rhythm after aortic unclamping were not different between two groups. Cardiac index and pulmonary capillary wedge pressure measured immediately after weaning from CPB, were not different in both groups. Lactate level was significantly low in group BCP. Lactate uptaking ratio of myocardium was significantly high in group BCP. CK-MB levels were not different between two groups. Cold blood cardioplegia was seemed to provide better aerobic myocardial metabolism during aortic cross clamp. However, CK-MB levels and hemodynamic studies were not different.
将间歇性逆行冷血心脏停搏与逆行晶体心脏停搏进行比较。22例成年患者接受心脏直视手术，分为两组。BCP组（n = 10）采用含钾15 mEq/l的15℃血液进行保护；CCP组（n = 12）采用4℃圣托马斯医院心脏停搏液进行保护。两组均在主动脉阻断后5分钟和15分钟以及体外循环（CPB）撤机后5分钟测量冠状窦血中的乳酸、丙酮酸和CK-MB水平。两组之间的CPB时间、交叉阻断时间、术后低心排血量综合征的发生率以及主动脉阻断后窦性心律的自发恢复情况无差异。CPB撤机后立即测量的心脏指数和肺毛细血管楔压在两组中无差异。BCP组的乳酸水平显著较低。BCP组心肌的乳酸摄取率显著较高。两组之间的CK-MB水平无差异。冷血心脏停搏似乎在主动脉交叉阻断期间能提供更好的有氧心肌代谢。然而，CK-MB水平和血流动力学研究无差异。
