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目的 观察在体外循环中应用大剂量抑肽酶对缺血再灌注的婴幼儿未成熟心肌的保护作用。方法 60例室间隔缺损合并肺动脉高压的婴幼儿进行随机对照实验 ,其中一半接受了大剂量抑肽酶的治疗 ,两组间在年龄、体重、性别、主动脉阻断时间和体外循环时间方面无显著性差异。在心脏复跳后 1 0分钟 ,取右心房心肌制成电镜标本 ,观察心肌超微结构的变化。分别于术前、术毕、术后 6小时、2 4小时、48小时抽取外周静脉血测定心肌肌钙蛋白I。记录术毕心脏自动复跳率、术后心率、血压、中心静脉压、尿量、心律失常发生率、中心温度与外周温度差。结果 抑肽酶组心脏自动复跳率、心肌超微结构的变化和心肌肌钙蛋白I的释放均明显优于对照组。结论 在体外循环中应用大剂量抑肽酶对未成熟心肌具有保护作用
Objective To observe the protective effect of high-dose aprotinin on cardiopulmonary bypass in infants with immature myocardium. Methods Sixty infants with ventricular septal defect and pulmonary hypertension were randomly divided into control group and half of them received high-dose aprotinin therapy. There were no significant differences in age, weight, sex, aortic block time and cardiopulmonary bypass time between the two groups Significant difference. In the heart after rebound 10 minutes, take the right atrial myocardium made of electron microscopy specimens to observe changes in myocardial ultrastructure. Peripheral venous blood samples were collected for the determination of cardiac troponin I at preoperative, postoperative, 6 hours, 24 hours, and 48 hours postoperatively. Recorded the heart rate of automatic rebound heart rate, postoperative heart rate, blood pressure, central venous pressure, urine output, arrhythmia incidence, central temperature and peripheral temperature difference. Results In aprotinin group, the rate of spontaneous rebound, changes in myocardial ultrastructure and cardiac troponin I release were significantly better than those in control group. Conclusion The application of high-dose aprotinin in cardiopulmonary bypass has a protective effect on immature myocardium