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目的：通过心脏手术中持续温血与间断冷血灌注的对照研究，以探索临床上更为有效的心肌保护方法，方法：应用含钾温血持续灌注与含钾冷血间断灌注心肌保护法行心内直视手术各15例，分别对其复跳情况、再灌注时间、心肌酶谱（AST，CK，CK－MB，LDH）及手术前后心功能变化进行对照分析。结果：持续温血组与间断冷血组自动复跳率分别为14／15和6／15（P＜0．05），再灌注时间分别为15．6±9．5min和25．5±8．2min（P＜0．05），超声心动图测得左心功能参数（手术前TTE结果与停机拔管后TEE结果之差）EF分别为8．77±5．80和-1．68±7．78（P＜0．05），FS分别为7．90±8．85和-1．97±6．40（P＜0．05），LVEDD分别为1．42±0．35和0．60±0．88（P＜0．05）。两组心肌酶谱除转流后CK温血组与冷血组分别为107．4±58．6和56．7±20．9IU（P＜0．05）外，其余各酶均无显著差异（P＞0．05）。结论：间断冷血灌注心肌保护法在临床上更为安全。
OBJECTIVE: To explore a more effective myocardial protection method through continuous warm blood perfusion and intermittent cold blood perfusion in cardiac surgery. Methods: The intracardiac Direct surgery were performed in 15 cases. The resuscitation, reperfusion time, myocardial enzymes (AST, CK, CK-MB, LDH) and the changes of cardiac function before and after surgery were analyzed respectively. Results: The spontaneous rebound rates in continuous warm-blooded and intermittent cold-blooded groups were 14/15 and 6/15 (P <0.05), and the reperfusion time was 15.6 ± 9.5 and 25.5 ± 8, respectively. (P <0.05). The EF of the left heart function measured by echocardiography (TEE before operation and TEE after extubation) were 8.77 ± 5.80 and -1.68 ± 7 .78 (P <0.05). The FS was 7.90 ± 8.85 and -1.97 ± 6.40 respectively (P <0.05), LVEDD was 1.42 ± 0.35 and 0 respectively. 60 ± 0.88 (P <0.05). Myocardial enzymes in the two groups were not significantly different from other enzymes (P <0.05), except for the CK warm-blooded group and the cold-blooded group after transfusion were 107.4 ± 58.6 and 56.7 ± 20.9 IU, respectively P> 0.05). Conclusion: Intermittent cold-perfusion myocardial protection is more clinically safe.