開心術에서 Bretschneider氏 및 St. Thomas Hospital 心停止液의 心筋保護效果에 關한 臨床的硏究 = A Clinical Study of the Effect on Myocardial Protection of Brestchneider's St. Thomas Hospital Cardioplegic Solutions During Open Heart Surgery

다국어 초록 (Multilingual Abstract)

Two kinds of cardioplegic solutions, Bretschneider's cardioplegic solution and St. Thomas Hospital cardioplegic solution were used to perform cardioplegia and myocardial protection for 100 patients who received open heart surgery, and effect of the two cardioplegic solutions on myocardial protection were compared. The patients were divided into two groups, the A group consisting of 70 patients who received Bretschneider's cardioplegic solution and the B group cosisting of 30 patients who received St. Thomas Hospital cardioplegic solution. Each group was further subdivided into 3 subgroups: (1) subgroup with aortic cross clamping time below 60 minutes, (2) subgroup with between 61 and 90 minutes and (3) subgroup with over 90 minutes. Effects of two cardioplegic solutions on the myocardial protection were evaluated by measuring and comparing levels of serum enzymes, SGOT, LDH, and CPK, and by observing incidence of positive findings of EKG for myocardial injuries in the study groups. The results obtained in the present study were as follows:
1) Incidence of percent positive for myocardial injuries were higher in the A group than in the B group by 2.3%(p<0.232), 0.5%(p<0.464), 2.3%(p<0.232), respectively when evaluated with SGOT, LDH, CPK levels, and by 0.9%(p<0.412) when evaluated by EKG findings. The results suggested that myocardial protection effect was observed to be better in the B group than in the A group.
2) In the study group with aortic cross clamping time below 60 minutes, the positive incidence for myocardial injuries was found two cases each (4.0%), respectively, when evaluated with SGOT, LDH and CPK in the A group, but no positive incidence was observed with any serum enzyme in the B group. The positive incidence for myocardial injuries was observed in one case (2.0%) with EKG findings, but no positive incidence was observed in the B group.(p<0.156).
3) In the study group with aortic cross clamping time between 61-90 minutes, the positive incidence for myocardial injuries in the A group was observed in one case each (6.6%), respectively, with SGOT and CPK, and two cases (13.3%) with LDH, but the positive incidence in the B group was found in one case (14.2%) only with LDH and not with SGOT and CPK (p<0.476). The positive incidence for myocardial injuries with EKG findings was observed in one case (6.6%) in the A group, but not in the B group (p<0.154).
4) In the study group with aortic cross clamping time over 99 minutes, the positive incidence for myocardial injuries was found in one case each (20.0%), respectively, with SGOT, LDH and CPK in both A and B groups. The positive incidence for myocardial injuries with EKG findings was also observed in one case each (20.0%) in both A and B groups.
5) With the results observed by present study, it can be concluded that the myocardial protective effect appeared to be better in the B group than in the A group in patients with aortic cross clamping time below 90 minutes, but not different between the A and B groups in patients with aortic cross clamping time over 90 minutes.