冷血心脏停搏液及低温心室颤动法在冠状动脉旁路移植术中心肌保护的效果（完整版）实用资料(可以直接使用，可编辑完整版实用资料，欢迎下载）冷血心脏停搏液及低温心室颤动法在冠状动脉旁路移植术中心肌保护的效果摘要：目的评价冷血心脏停搏液和低温心室颤动法在冠状动脉旁路移植术(CABG)中心肌保护的临床效果。方法根据不同的心肌保护方法，将2013例患者分为两组，冷血心脏停搏液组：596例采用冷血心脏停搏液保护心肌；低温心室颤动组：1417例采用低温心室颤动法保护心肌。两组均为单纯、择期CABG手术，观察心肺转流术(CPB)时间，升主动脉阻断时间，ICU监护期，住院死亡率，主动脉内气囊泵(IABP)使用率，中枢神经系统并发症及肾功能衰竭发生率。结果术中冷血心脏停搏液组与低温心室颤动组旁路移植血管支数无差异，冷血心脏停搏液组CPB时间、升主动脉阻断时间明显长于低温心室颤动组(P＜0.01)。术后ICU监护期、中枢神经系统和肾功能衰竭并发症及术后住院死亡率两组间无差异。结论单纯、择期CABG手术患者，低温心室颤动法仍是一种安全、有效的心肌保护方法，其临床效果可能优于冷血心脏停搏液法。关键词：冷血心脏停搏液心室颤动冠状动脉旁路移植术心肌保护中分类号：R654.2文献标识码：A文章编号：1007-4848(2000)03-0163-04ClinicalOutcomesofColdBloodCardioplegiaandIntermittentCross-ClampingasMyocardialPreservationinCoronaryArteryBypassGraftingLIUZhi-yong,TomTreasure.Abstract:ObjectiveInordertoassessandevaluatetheclinicalresultsofcoldbloodcardioplegiaandintermittentcross-clampingasmyocardialpreservationincoronaryarterybypassgrafting(CABG).MethodsAccordingtothemanagementmethods,2013casesforelective,isolatedCABGweredividedintotwogroupsatSt.George'sHospital,London.Coldbloodcardioplegiagroup:596patientstreatedwithcoldbloodcardioplegia,andhypothermicventricularfibrillationgroup:1417patientstreatedwithintermittentcross-clampingischemiaandhypothermicventricularfibrillation.Thevariablesusedforassessmentwerecardiopulmonarybypasstime,cumulativecross-clampingtime,hospitalmortality,intensivecareunitstay,usageofintro-aorticballoonpumpandstrokeandrenalfailureincidence.ResultsTherewasnosignificantdifferencesforgraftsbetweencoldbloodcardioplegiagroupandhypothermicventricularfibrillationgroup.Cardiopulmonarybypasstimeandcross-clampingtimewasfoundtobelongerincoldbloodcardioplegiagroupthanthatinhypothermicventricularfibrillationgroup(P＜0.01).Therewerenosignificantdifferencesinin-hospitalmortality,intensivecareunitstayandothercomplicationsbetweenthetwogroups.ConclusionIntermittentcross-clampingwithhypothermicventricularfibrillationisstillaseffective,safeastrategytoprotectthemyocardiumascoldbloodcardioplegiaforelective,isolatedcoronaryarteryope