目的 探讨自制降主动脉球囊插管在深低温停循环猪模型中的有效性与安全性.方法 选取健康普通猪12只,体质量(48.3±0.9)kg,开胸建立体外循环,逐步降温至鼻咽温20℃,建立深低温停循环模型,随机分为两组(n=6).A组为实验组:深低温联合降主动脉顺行灌注;B组为对照组:单纯深低温停循环;分别于麻醉诱导后(T1)、体外循环开始(T2)、恢复循环后5min(T3)、复温至36℃(T4)采集血液样本,检测血气、乳酸、血糖、血肌酐、尿素氮.结果 与B组比较,在T3时间点,A组的PH、动脉血氧分压、静脉血氧饱和度高,二氧化碳分压较低,差异有统计学意义(P<0.05);T3、T4点的乳酸、血糖、血肌酐、尿素氮A组均低于B组(P<0.05);两组T3、T4点的乳酸、血糖、血肌酐、尿素氮均高于T1(P<0.05).结论 自制降主动脉球囊插管顺行灌注可以减轻深低温停循环的引起损害.本研究证实此方法在猪深低温停循环模型中安全、有效.%Objective To investigate the effectiveness and safety of self-designed descending aorta perfusion catheter with balloon occlusion in the swine model of deep hypothermic circulatory arrest(DHCA). Methods 12 healthy swines,(48.3±0.9)kg by weight,routine cardiopulmonary bypass (CPB)was established after median thoracotomy,when the nasopharyngeal temperature dropped down to 20℃,DHCA was started.12 models were randomly divided into 2 groups(n=6):Study group(A):DHCA combined with antegrade perfusion through the descending aorta and Control Group (B):DHCA blood samples were taken immediately after anesthesia induction(T1),after CPB(T2),and 5minuetes after circulatory restoration (T3);re-warming the temperature to 36.5℃(T4). Arterial blood gas analysis,lactate levels,glucose,serum cratinine,blood urea nitrogen were measured. Results The pH value,arterial blood p(O2),p(CO2)at T3 time point in group(A)were significantly higher than that in the group(B) (P<0.05). Lactate levels,glucose,serum cratinine,blood urea nitrogen at T3,T4 time points in group(A)were significantly lower than that in the group(B)(P<0.05). Lactate levels,glucose,serum cratinine,blood urea nitrogen at T3,T4 time points in both groups were significantly higher than that at T1 time point(P<0.05). Conclusion Antegrade perfusion through the descending aorta with self-designed balloon occlusion perfusion catheter shows advantages in protecting against the impairment of DHCA. The current study demonstrates that DHCA in the swine model is safe and effective.
展开▼
