摘要目的 探讨含乌司他丁自体冷血心脏停搏液对婴儿体外循环心脏直视手术心功能的影响.方法 年龄≤10个月行体外循环室间隔缺损修补术的患儿60例,应用随机数字表法随机分成自体冷血停搏液组30例(A组)、含乌司他丁冷血停搏液组30例(B组).分别于主动脉开放后1、6h测量左心做功指数(LCWI)、心脏指数(CI)及每搏指数(SI),监测术中心脏复跳时间及复跳率,正性肌力药物依赖情况.结果 两组自主复跳率差异无统计学意义(P＞0.05)；B组心脏自动复跳时间[(34.2±4.7)s]及正性肌力药物依赖[40.0％ (12/30)]均明显低于A组(52.1±6.5)s和66.7％ (20/30),差异有统计学意义(=2.001、t=1.895,P均＜0.05)；B组术后不同时点CI及SI、LCWI高于A组,差异有统计学意义(P均＜0.05).结论 含乌司他丁自体冷血停搏液利于婴儿体外循环直视手术后心脏功能恢复,对未成熟心肌有良好的保护作用.

abstractsObjective To investigate the effects of ulinastatin-containing autologous cold blood cardioplegic solution on the cardiac function of infants after cardiopulmonary bypass surgery.Methods Sixty infants younger than 10 months old,who underwent ventricular septal defect repair under cardiopulmonary bypass,were randomized into autologous cold blood cardioplegia group (30 patients,Group A)and ulinastatincontaining cold blood cardioplegia group (30 patients,Group B).CI,SI and LCWI were monitored 1 and 6 hours after opening the aorta.The time and rate of cardiac resuscitation,as well as the dependence on the inotropic drugs,were intraoperatively monitored.Results The automatic resuscitation rate in two groups was not siynificantly ( P ＞ 0.05).The time for automatic resuscitation were (34.2 ± 4.7) s and (52.1 ± 6.5 ) s for Group B and Group A,respectively ( P ＜ 0.05 ).The rate of dependence on inotropic drug were 40.0％ (12/30) and 66.7％ (20/30)for Group B and Gro~p A,respectively (P ＜ 0.05).Mter the operation,the CI,SI and LCWI of group B were higher than that of group A ( P ＜0.05 ).Conclusion Ulinastatin-containing autologous cold blood cardioplegic solution is beneficial to the functional cardiac recovery of the infants after heart bypass surgery by protecting the immature myocardium.