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随着心内复杂手术的开展,心肌保护日益受到重视。以往,大多只注意在阻断主动脉后心脏迅速停跳,降低心脏温度,以降低心肌新陈代谢,减少心肌能量消耗。目前认为,术前术中应用能量基质可增加能量储备,提供术中无氧代谢能量,是围术期心肌保护的重要环节之一。一、心脏能量代谢的转移在冠状动脉灌注心脏时,心肌能量由有氧代谢产生,心肌主要氧化脂肪酸、葡萄糖。主动脉阻断时,能量来源取自(1)由非冠状
With the development of complex intracardiac surgery, myocardial protection is gaining more and more attention. In the past, most of them only paid attention to the rapid stop of the heart after blocking the aorta, lowering the temperature of the heart to reduce the myocardial metabolism and reduce the myocardial energy consumption. It is currently believed that the application of energy matrix before surgery can increase energy reserves, provide intraoperative anaerobic metabolic energy is one of the important aspects of perioperative myocardial protection. First, the transfer of cardiac energy metabolism During coronary perfusion of the heart, myocardial energy produced by aerobic metabolism, myocardial oxidation of fatty acids, glucose. When the aorta is blocked, the source of energy is taken from (1) by a non-coronal