体外循环心肌损伤及心肌保护的研究进展

Research progress in myocardial injury and protection during extracorporeal circulation

摘要:

人工心肺体外循环(ECC)是一项比较成熟的心外科生命支持技术,ECC的发明使切开心脏和大血管进行直视手术成为可能。但ECC诱发的心脏等重要脏器的损伤是除手术效果外影响患者预后的决定性因素,严重者会对手术患者的预后造成显著影响。尽管在过去几十年里,随着ECC保护措施的进步,使 ECC后心肌等重要脏器的损伤显著下降,但是 ECC自身的技术特点决定了 ECC导致的心功能下降仍然存在。本综述浅述了 ECC诱导心肌损伤的部分病理机制以及降低心肌损伤的可行措施。

Abstract:

Extracorporeal circulation (ECC) is a mature life support technology used for cardiac surgery, and its invention made it possible to cut open the heart and large blood vessels for direct vision surgery. Besides effects of the surgery, however, ECC-induced injuries on such important organs as the heart is the critical influencing factors of the patient′s prognosis. In case of serious injury, postoperative prognosis can be significantly affected. Over the decades, enhanced proactive measures have attenuated the extent of the myocardial injury, but decline in cardiac function exists because of the technical characteristics of ECC itself. This article reviews the pathological mechanism of ECC-induced myocardial injury and feasible measures to attenuate its extent.