体外循环期间钙动态变化的研究

观察32例患者体外循环期间血浆及红细胞内钙的动态变化。目的在于揭示其变化规律，为更好的保护心肌提供新的措施和理论依据。结果：麻醉后体外循环前血浆钙较术前显著升高，体外循环开始显著下降；40min恢复至术前水平；停机时显著升高至停机8h。术前、中、后红细胞内钙无显著变化。体外循环期间钙变化与血液稀释、应激反应、预充液及心脏停跳液中含钙离子有关。高钙可导致心肌缺血及再灌注时大量钙进入心肌细胞，引起心肌细胞损伤。所以，体外循环期间，特别是复灌期适当降低钙浓度，对术中、后心肌功能恢复具有重要作用。     

新型多功能心血管内径测量器的研制及应用

新型多功能心血管内径测量器 ,使用纯钛材料制成 ,由连杆采用氩弧焊方式两端联接测量探头组成。连杆长 1 50 mm,直径 2 .5mm,可任意弯曲 ;测量探头长 55mm,直径 1 9mm～ 35mm,探头上刻有直径刻度。用于心脏手术二尖瓣替换及三尖瓣成形、室间隔缺损修补、Bentall手术、法乐氏三联症等心血管内径的测量和扩张。经临床 50例的手术应用 ,效果满意     

41 CASES REPORT OF CLINICAL APPLICATION OF MITRAL VALVE RECONSTRUCTION

４１ＣＡＳＥＳＲＥＰＯＲＴＯＦＣＬＩＮＩＣＡＬＡＰＰＬＩＣＡＴＩＯＮＯＦＭＩＴＲＡＬＶＡＬＶＥＲＥＣＯＮＳＴＲＵＣＴＩＯＮ（李兆志）（黄庆恒）（耿希刚）ＬｉＺｈａｏｚｈｉ；ＨｕａｎｇＱｉｎｇｈｅｎｇ；ＧｅｎｇＸｉｇａｎｇ；（ＤｅｐａｒｔｍｅｎｔｏｆＣ...     

体外循环期间钙动态变化的研究

观察32例患者体外循环期间血浆及红细胞内钙的动态变化。目的在于揭示其变化规律，为更好的保护心肌提供新的措施和理论依据。结果：麻醉后体外循环前血浆钙较术前显著升高，体外循环开始显著下降；40min恢复至术前水平；停机时显著升高至停机8h。术前、中、后红细胞内钙无显著变化。体外循环期间钙变化与血液稀释、应激反应、预充液及心脏停跳液中含钙离子有关。高钙可导致心肌缺血及再灌注时大量钙进入心肌细胞，引起心肌细胞损伤。所以，体外循环期间，特别是复灌期适当降低钙浓度，对术中、后心肌功能恢复具有重要作用。     

室间隔缺损并肺动脉高压102例外科治疗

先天性心脏病室间隔缺损（ＶＳＤ）是一常见多发病，由于存在左向右分流，常导致肺动脉高压（ＰＨ），使围手术期死亡率增加，预后不佳，故早期发现、早期手术治疗己被重视。本文对１０２例ＶＳＤ·ＰＨ患者外科手术治疗进行分析，并对手术适应症、手术径路、并发症预防及术后处理进行讨论。     

THE STUDY ON THE CHANGES OF ZINC, COPPER, CALCIUM AND MAGNESIUM IN PLASMA AND ERYTHROCYTES DURING CARDIOPULMONARY BYPASS

Objective To study the changes and their influence factors involved of zinc, copper, calcium and magnesium in plasma and erythrocytes during cardiopulmonary hypass(CPB). Methods Zinc, copper, calcium and magnesium values in plasma and erythrocytes were measured by atomic absorption spectrophotometer during CPB. Results Zinc and copper levels in plasma were significantly elevated above preinduction level before perfusion, hut calcium and magnesium levels did not change significantly; zinc, copper and calcium levels in plasma were significantly below preoperation level during CPB, hut magnesium level in plasma was significantly increased above preoperation; zinc level in plasma was increased to preoperation level after CPB and began to decrease again at 8 hours after CPB,copper level in plasma was increased to preoperation level at 20 hours after CPB, calcium in plasma was increased significantly from beginning to 8 hours after CPB, magnesium level in plasma was decreased to preoperation level at 8 hours afterCPB. Concentration of zinc , copper, calcium and magnesium in erythrocytes did not change significantly. Conclusion During CPB, the changes of zinc, copper, calcium and magnesium had relation to hemodilution, operative wound, carrier protein, stress and component of priming Solution and cardioplegic solution, hut no relation to transferfrom plasma erythrocytes. The results indicate that it is beneficial to patient‘s recovery to supplement zinc, copper, calcium and magnesium properly by different ways during cardiac perioperation.     

室间隔缺损并肺动脉高压患者临床指标与肺超微结构的比较

目的　探讨室间隔缺损合并肺动脉高压临床资料与肺超微结构的关系。方法　分别应用心导管术观察室缺患者右心及肺循环血流动力学指标 ;应用透射电镜观察肺超微结构的变化 ,且二者进行对比。结果　肺血流动力学指标与肺超微结构变化之间无明显统计学关系。结论　室间隔缺损合并肺动脉高压的成因除牵张刺激及剪切应力外 ,肺血管本身发育异常可能是主要原因     

体外循环期间微量元素锌、铜动态变化的研究

观察32例患者体外循环期间血浆及红细胞内锌、铜的动态变化。结果:麻醉后体外循环前血浆锌较术前显著升高,而铜无显著变化;体外循环期间,血浆锌、铜较术前显著降低;血浆锌停机后恢复近术前水平,停机8h又出现下降,血浆铜停机20h恢复近术前水平。红细胞内锌、铜无显著变化。体外循环期间锌、铜变化与血液稀释、手术创伤、载体蛋白及应激因素有关。适量增高锌、铜浓度,有利于提高超氧化物歧化酶等的活性,减轻心肌缺血及再灌注损伤。     

自体心包修复心血管畸形或病变850例报告

目的总结利用自体心包片作为修补或管道连接材料用于心血管畸形或病变矫治中的临床经验。方法850例患者在全麻下实施心脏、血管直视手术。术中获取大小合适的心包片,应用于间隔缺损修补、房间隔重建、流出道加宽、外管道制作与吻合,以及瓣膜成形等手术。结果手术死亡11例,均与心包片应用无关。痊愈出院839例,术后3～6个月内门诊体检,心动超声图检查218例(约占26%),2例仍存在术前的三尖瓣中度关闭不全,1例右心功能不全,其余疗效尚满意。无1例发生因选用心包所致的相关并发症,如动脉瘤样膨出、补片残余漏等。结论自体心包片是心血管疾病矫治中不可多得的修复材料,早期疗效良好,晚期效果有待于进一步观察研究。     

VALVE REPLACEMENT WITH BILEAFLET HEART VALVE PROSTHESIS: FOLLOW-UP OF 170 CASES

FromFeb.1989toMay1996,170patientsunderwentvalvereplacementwith202bileafletheartvalvepr0stheses.Therewerel3earlydeaths,and6latedeaths.Afterthefollow-up0fthesurviv0rsfor3to87(average39)months,weanalysedtheclinicalapplicati0n0fthebileafletheartvalvepr0sthesesasf0ll0ws.CLINICALDATA1GeneraldataTherewere1O5maleand65femalepatients,agedfrom14to65(average44)yearsold.Theconditionofvalvelesions:l6casesofrheumaticmi-tralstenosis,1lincompetence,67sten0siswithincompetence,5resten0sisafterclosedcommis…