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本研究的目的是建立心脏直视手术的动物(山羊)模型。动物都在体外循环下,用心脏停跳液冷灌冠状动脉使心脏停跳,对部分动物并加作左心房切开和二尖瓣检测,以及房室压的测定。 本文报道了1984年2月至6月所作的13只山羊的手术。其中6只于手术的当天死亡,7只长期存活,长期存活率约为54％。如果排除因意外失血的2只动物,则长期存活率约为64％。部份采取(第一组,心脏停跳30分钟)或全部采取(第二组,心脏停跳45和60分钟)了上述的保护肺的措施的动物,则能长期存活(第一组的二只,第二组的五只)。由于手术例数少,不能说保护肺的措施有绝对的意义,但却说明了这种措施在心脏直视手术的重要性。在通过体外循环下使心跳停止45分钟的实验后,就不难增加切开左房作二尖瓣检测和房室压力测定,也不难将停跳时间延长至60分钟。 术后当天死亡的六只动物的肺都有严重的实变,而且手术时的下位肺(右侧)更为严重。 本研究所采取的保护肺脏的措施为:体外循环期间,气道压力波动于5～15cmH_2O之间,以利肺的扩张。术后使动物取腹卧位,并常改变其体位,以利胃内气体排除和预防下垂性肺病变。术后使动物取前高后低的倾斜位,以减少胸腔内的血流量,有利于防止肺水肿。
The purpose of this study was to establish animal (goat) models of open heart surgery. Animals are under cardiopulmonary bypass, with cardioplegic fluid cold filling the coronary arteries to stop the heart, and on some animals plus left atrial septal and mitral valve detection, and determination of ventricular pressure. This article reports on the operation of 13 goats from February to June 1984. Of these, 6 died on the day of surgery and 7 survived long-term, with a long-term survival rate of 54%. Long-term survival was about 64% if two animals that lost blood due to an accident were excluded. Animals that took part in the above-mentioned measures to protect the lungs (Group 1, Cardiac arrest for 30 minutes) or all (Group 2, Cardiac arrest 45 and 60 minutes) were able to survive long term Only, the second group of five). Due to the small number of operations, the failure to say that the measures to protect the lungs are of absolute significance, but it shows the importance of such measures in open heart surgery. After cardiopulmonary bypass is stopped for 45 minutes by cardiopulmonary bypass, it is not difficult to increase the left atrium for mitral valve examination and atrial pressure measurement, and it is not difficult to extend the stop-motion time to 60 minutes. The lungs of the six animals that died on the day postoperative had severe consolidation and the lower lung (right side) was more severe during surgery. The measures taken to protect the lungs in this study are as follows: during cardiopulmonary bypass, the airway pressure fluctuates between 5 and 15 cmH 2 O to facilitate lung expansion. Postoperative animals to take abdominal position, and often change its position to facilitate the elimination of gastric gas and prevent sagging pulmonary disease. After the animals take the high and low after the tilt position to reduce the blood flow within the chest, is conducive to preventing pulmonary edema.