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高压氧对暂时性缺血心肌的保护作用。大体及组织学数据。

Protective effect of hyperbaric oxygen for the temporary ischaemic myocardium. Macroscopic and histological data.

作者信息

Kawamura M, Sakakibara K, Sakakibara B, Kidokoro H, Takahashi H, Kobayaski S, Konishi S, Uno Y

出版信息

Cardiovasc Res. 1976 Sep;10(5):599-604. doi: 10.1093/cvr/10.5.599.

Abstract

A protective effect of hyperbaric oxygen immediately after reopening of occluded coronary blood flow for the temporary ischaemic myocardial muscle was studied. Thirty dogs were used in this study, and 20 dogs were sacrificed after 4 h and 10 dogs were sacrificed after 5 d. Temporary occlusion of coronary artery (from 30 min to 2 h) was produced by ligation. One group were controls and the other group were a hyperbaric group in which dogs breathed 100% oxygen at an absolute pressure of 2 atmospheres before and after release of coronary ligation. The macroscopic extent of ischaemic area was studied by using nitroblue tetrazolium and microscopic and ECG findings were examined. By breathing oxygen at high pressure immediately after reopening of occluded coronary blood flow, the ischaemic area was markedly reduced. In such cases, some myocardial muscles around the arterioles and sinusoids, even when these vessels existed in the ischaemic area, were kept in a viable state. The repair of necrotic myocardial muscles was promoted histologically. Serious arrhythmia, especially ventricular fibrillation, was also well suppressed, and the stable haemodynamic conditions were obtained during operative procedures. No harmful side effects of hyperbaric oxygen were observed. One of the most effective treatments of acute myocardial infarction involves reconstruction of the occluded coronary artery as soon as possible after the onset of myocardial infarction by using these advantages of hyperbaric oxygen.

摘要

研究了在闭塞的冠状动脉血流重新开放后立即给予高压氧对短暂缺血心肌的保护作用。本研究使用了30只犬,其中20只在4小时后处死,10只在5天后处死。通过结扎造成冠状动脉暂时闭塞(30分钟至2小时)。一组为对照组,另一组为高压氧组,在冠状动脉结扎松开前后,该组犬在2个绝对大气压下呼吸100%氧气。使用硝基蓝四氮唑研究缺血区域的宏观范围,并检查微观和心电图结果。在闭塞的冠状动脉血流重新开放后立即呼吸高压氧,缺血区域明显缩小。在这种情况下,即使小动脉和血窦存在于缺血区域,其周围的一些心肌仍保持存活状态。组织学上促进了坏死心肌的修复。严重心律失常,尤其是室颤也得到了很好的抑制,并且在手术过程中获得了稳定的血流动力学状况。未观察到高压氧的有害副作用。利用高压氧的这些优势,急性心肌梗死最有效的治疗方法之一是在心肌梗死发作后尽快重建闭塞的冠状动脉。

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