Kuraoka S, Orita H, Shimanuki T, Kohno M, Fukasawa M, Inui K, Washio M
Rinsho Kyobu Geka. 1989 Apr;9(2):173-5.
Blood cardioplegia has recently been advocated as a superior method of myocardial protection, but its temperature is important, and it has not been compared to a magnesium containing crystalloid cardioplegia. This study was undertaken to compare the protective effect of cold blood cardioplegia (BCP) and cold crystalloid cardioplegia with or without magnesium (MgKCP and KCP). Fourty-five patients were undertaken prosthetic cardiac valve replacement with left ventricular volume overload from valvular regurgitation. They were divided into three groups for the difference of the cardioplegic solution. Intraoperatively, myocardial temperature and the tissue PCO2 was monitored, and the content of calcium and magnesium of right atrium was measured before and after aortic cross clamping. Postoperatively, left ventricular stroke work index and serum CPK-MB isozyme activity were measured at 3, 6, 24 and 48 hours after weaning from cardiopulmonary bypass. The increase of the tissue PCO2 during aortic cross clamping and its recovery at ten minutes after reperfusion were significantly suppressed in BCP. The retension of the tissue calcium after reperfusion and calcium to magnesium ratio were significantly low in MgKCP. The recovery of cardiac pump function and decrease of CPK-MB were superior in MgKCP.
血液停搏液最近被倡导为一种更好的心肌保护方法，但其温度很重要，并且尚未与含镁晶体停搏液进行比较。本研究旨在比较冷血停搏液（BCP）以及含镁和不含镁的冷晶体停搏液（MgKCP和KCP）的保护效果。45例因瓣膜反流导致左心室容量超负荷而接受人工心脏瓣膜置换术的患者，根据停搏液的不同分为三组。术中监测心肌温度和组织PCO2，并在主动脉阻断前后测量右心房的钙和镁含量。术后，在脱离体外循环后3、6、24和48小时测量左心室每搏功指数和血清CPK-MB同工酶活性。BCP组在主动脉阻断期间组织PCO2的升高及其在再灌注后10分钟的恢复受到显著抑制。MgKCP组再灌注后组织钙的潴留和钙镁比显著降低。MgKCP组心脏泵功能的恢复和CPK-MB的降低更为显著。
