康斯特保护液在婴幼儿心内直视手术中对心肌的保护作用  

Effects of Custodial Histidine-Triptophan-Ketoglutalate Solution on Myocardial Protection in Infants' Open Heart Surgery

作　　者：王秀华[1] 贾兵[1] 叶明[1] 钟慧[1] 何春兰[1] 

机构地区：[1]复旦大学附属儿科医院心血管中心外科,上海201102

出　　处：《实用儿科临床杂志》2010年第13期1009-1010,共2页Journal of Applied Clinical Pediatrics

基　　金：上海市重点学科建设项目(B116)

摘　　要：目的比较康斯特保护液(HTK液)和托马斯液(ST.Thomas液)在婴幼儿心内直视手术中对心肌的保护作用。方法选取40例VSD婴幼儿,分为实验组(HTK液)20例和对照组(ST.Thomas液)20例。患儿均采用常规全身麻醉。体外循环(CPB)采用中度低温。肝素化后常规建立CPB。升主动脉阻断后,经主动脉根部顺行灌注停搏液。实验组灌注HTK液30～50mL·kg-1,灌注时间持续6～8min。对照组灌注ST.Thomas液10～15mL·kg-1。观察指标包括主动脉开放后心脏自动复跳率、术后呼吸机支持时间及ICU监护时间。并对结果进行统计分析。结果 2组患儿CPB时间及主动脉阻断时间比较差异均无统计学意义(Pa>0.05)。2组患儿主动脉开放后心脏自动复跳率实验组显著高于对照组(P<0.05)。实验组辅助循环时间、停CPB后多巴胺剂量、术后呼吸机支持时间和ICU监护时间均少于对照组,差异均有统计学意义(Pa<0.05)。结论 HTK液可减轻未成熟心肌的缺血再灌注损伤,有利于早期心功能的恢复。与传统的ST.Thomas液比较,其对婴幼儿的未成熟心肌的保护作用更强。Objective To compare the effects of custodial histidine - triptophan - ketoglutalate（HTK） solution and ST. Thomas solution on myocardial protection in infants＇ open heart surgery. Metbodl~ Forty infants with ventricular septal defect were divided into 2 groups：HTK solution group （ n = 20） and ST. Thomas solution group （ n = 20）. The moderate hypothermia of body were maintained during eardiopulmaonary bypass （ CPB ）. In HTK group, HTK solution were perfused 30 - 50 mL·kg^-1 in 6 - 8 minutes. In ST. Thomas group, ST. Thomas solution were perfused 10- 15 mL ·kg^-1. Spontaneous resuscitation rate, the requirement for dopamine at the end of CPB, incubation time and the time stayed in intensive care unit were evaluated. Results There was no significant difference in CPB time and aorta clamp time between the 2 groups. Spontaneous resuscitation rate in HTK group was higher significantly than that in ST. Thomas group （P 〈 0.05 ）. The requirement for dopamine at the end of CPB,incubation time and mean time in ICU in HTK group were lower significantly than those in ST. Thomas group （ P 〈 0.05 ）. Conclusions Compared with the conventional ST. Thomas solution, HTK solution can decrease the isehemia - reperfusion injury and be benefit for the recovery of heart function. The protective effects of HTK solution on immature myocardium in infants＇ open heart surgery is obviously better than conventional ST. Thomas solution.

关 键 词：体外循环 心脏停搏液 心肌保护 婴幼儿 

分 类 号：R726.5[医药卫生—儿科]