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维普资讯 l40 新医学 2005年 3月第36卷第 3期 不停跳心内直视手术对心肌损伤的探讨 山东大学山东省立医院心外科 (250021) 张海洲 郭兰敏 邹承伟 杨丽娟 李 杨 南京中医药大学附属医院胸心外科 (210000) 薛 涛 一～一一一～一一～一一一一～一一一一一一一一一～ [关键词] 心脏不停跳 心肌 心肌损伤 体外循环 房间隔缺损 室间隔缺损 一一一～～一一一一～一 Investigationofmyocardialinjuryinbeatingheartsurgeryduringcardiopulmonary bypass．ZhangHaizhou，GuoLanmin，Zou Chengwei，eta1．DepartmentofCardiovascularSurgery，ShamMngPrvoincialHospital，JihanShandong，250021，China ：Abstract objective：Toevaluatetheeffectsofbeatingheartsurgeryonmyocardialinjuryduringcardiopulmonaubypass (CPB)．Methods：Forty—eightpatientswererandomlydividedintotwogroups：experimentalrgoup(n=24)，receivedsurgeryon beatingheartwithmildhypothermia(31～34℃)duringCPB；controlgroup (n=24)，receivedoperationonarrestedheartwith 一一一一～一一一～一一 moderatehypothermia (28～30℃)duringCPB．DurationofCPB，postoperativemechanicalrespiratoryassistanceduration，chesttube drainageandthetimeofpostoperativehospitalstaywerecomparedbetweenthetworgoups．Bloodsamplesweretakenfrom artery before operationand2．6，24 hoursafteroperation．AST，CK—MB andtheactivityofSOD weremeasured．Myocardialtissuesweretaken from fightatrium forobservationofultra—structuralchanges、Results：DurationofCPB，postoperativemechanicalrespiratoryassistance durationandchesttubedrainageweresignificantlylessinexperimentalgroup(P0．05orP0．01)．Therewasnosignificantdiffer— enceinthetimeofpostoperativehospitalstaybetweenthebothgroups(P0、05)、Post—operativeASTandCK—MBweresignificantly 一一一一一一一～一一一 higherthanpre—operativevalues．withmoreprominentelevationinthecontrolgroup(P0、05orP0．01)、However，thepost—opor- ativeactivityofSODwassigni