关键词:急性心肌缺血;激光心肌血管建术;心肌血流量
【摘要】 目的 本实验观察了激光心肌血管重建术(TMLR)后心肌血流量的变化,探讨TMLR的作用机制。方法 18只犬随机等分为三组:A组-对照组;B组-缺血组;C组-激光组。采用连续型Nd∶YAG激光行心肌打孔,光纤直径0.6 mm,功率20~25 W,脉冲时间0.3~0.5 s,孔间距离8~10 mm。于LAD结扎前、结扎后30 min和60 min收集冠状静脉窦血计算心肌血流量。统计学处理采用随机区组设计的方差分析(α=0.05)。结果 缺血组LAD结扎后心肌血流量进行性下降(P<0.05),而激光组LAD结扎前后比较无显著性差异(P>0.05),但结扎后明显高于缺血组(P<0.05)。结论 TMLR可迅速有效地改善心肌缺血。
Change and significance of myocardial blood flow after TMLR opration in AMI dogs
Chen Ju, Sun Peiwu, Zhang Huizhong, et al. Department of Cardiothoracic Surgery, Memorial Hospital, Sun Yat-Sen University of Medical Sciences, Guangzhou 510120
【Abstract】 Objective For observing change of myocardial blood flow (MBF) after TMLR in the dogs with experimental AMI to detect the mechanism of TMLR effect. Method 18 mongrel dogs were randomly put into three groups (n=6 in each group): A-control. B-AMI. C-TMLR. Continuous wave Nd:YAG laser was used to create the transmural channels in the ischemic area, with light-guided fiber of 0.6 mm in diameter, laser power 20~25 watt, 0.3~0.5 sec/pulse, and interpore distance of 8~10 mm. Myocardial blood flow was calculated by collection of the blood from the coronary sinus immediately before the LAD ligation, and 30 and 60 minutes after the LAD ligation. Statistical analysis was done by rank test (α=0.05).Result MBF was less 30 and 60 minutes after the LAD ligation not only than before the LAD ligation in the AMI group (P<0.05), but also than in other two groups (P<0.05), while it kept increasing after the LAD ligation in the TMLR group (P>0.05).Conclusion This study showed that the TMLR could effectively improve myocardial ischemia. 【Key words】 AMI TMLR MBF
激光心肌血管重建术(Transmyocardial Laser Revascularization, TMR)是近年发展起来并已谨慎临床应用的冠心病外科治疗新方法 ......
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