不同年龄患者心脏不停跳心内直视术的心肌保护效果  

Effects of myocardial protection in different age paitents on beating heart surgery under cardiopulmonary bypass

作　　者：黄海清[1] 秦科[1] 张炳东[1] 陈燕桦[1] 涂杰[1] 刘国锋[1] 梁蓓薇[1] 

机构地区：[1]广西医科大学第一附属医院心血管病研究所,南宁市530021

出　　处：《广西医学》2007年第5期647-649,共3页Guangxi Medical Journal

摘　　要：目的评价不同年龄患者应用体外循环心脏不停跳法行心内直视手术的心肌保护效果。方法在拟行先天性心脏病房间隔缺损或室间隔缺损修补术的病人中,按年龄<3岁、3～12岁、≥12岁分为3组,各组随机选择30例病人,在静吸复合麻醉下行体外循环心脏跳动中房间隔修补术或室间隔修补术。在切皮前、转流前、停机后10min、手术毕等时点取动脉血作心肌肌钙蛋白I(cTnI)浓度检测,并观察术中及术后病人的恢复情况。结果各组停机后的cTnI浓度值均比转流前增高(P<0.01)。婴幼儿组cTnI浓度的增高幅度较其他组高,且术后恢复效果相对较差(P<0.05)。结论3岁以上患者应用体外循环心脏不停跳法行心内直视手术的心肌保护效果优于婴幼儿。Objective To evaluate the myocardial protective effects of beating heart surgery in patients of different ages during eardiopulmonary bypass （CPB）. Methods Ninety patients with artrial septal defect and ventrieular septal defect, were randomly divided into three groups（ n = 30 in each group ） ： group 〈 3 years, group 3 - 12 years, group ≥ 12 years. All patients were performed beating heart surgery under CPB with vein and inhalation combined anesthesia. The arterial blood samples were taken for determination of plasma myocardial troponin I concentrations before incision （ T1 ）, before CPB （ T2 ）, 10 minutes after arresting of CPB （ T5 ）, at the end of operation （T6 ）, respectively. The recovery of heart during and after operation were observed. Results All patients showed significant increases in eTnI levels after CPB （ P 〈 0.01 ）. The levels of cTnI was higher singnifieantly in the group 〈 3 years than those in other two groups （ P 〈 0.05 ）. The group 〈 3 years recovered relatively bad. Conclusion The myocardial protective effect of beating heart, surgery in ≥3 years patients with CPB is better than that in 〈3 years group.

关 键 词：体外循环 心脏不停跳手术 心内直视术 心肌保护 

分 类 号：R654.1[医药卫生—外科学]