婴幼儿法洛四联症根治术应用不同心肌保护液的效果观察  

Observation of myocardial protective effects of different cardioplegias applied during radical correction of tetralogy of Fallot in infants

作　　者：敦静[1] 王伟[2] 龚琪[3] 王哲[3] 

机构地区：[1]河北医科大学第四医院手术室,石家庄050011 [2]河北省成安县人民医院外科 [3]河北医科大学第四医院胸心外科

出　　处：《西南国防医药》2011年第2期151-154,共4页Medical Journal of National Defending Forces in Southwest China

基　　金：河北省卫生厅科技支撑计划(20090458)

摘　　要：目的探讨左旋精氨酸和腺苷联合应用对婴幼儿法洛四联症根治术的心肌保护作用。方法拟行心内直视手术的婴幼儿法洛四联症患者60例,随机分为对照组(A组)、L-精氨酸(L-Arg)组(B组)、腺苷组(C组)和联合用药组(D组),每组各15例。A组给予常规冷晶心肌保护液,B组于给予含2.5g/LL-Arg心肌保护液,C组给予含2.5g/L腺苷心肌保护液和D组给予含L-Arg和腺苷两种药物心肌保护液。结果用药组与A组以及用药组之间分别自动复跳率比较无明显差异,但非自动复跳者电复律次数D组较A组明显减少(P<0.05);D组机械辅助通气时间明显低于A组(P<0.05),而ICU停留时间D组与A组、B组和C组比较明显缩短,D组多巴胺用量低于A组(P<0.05),而D组与B组和C组比较无明显差异。D组和B组住院天数较A组明显缩短,用药组住院费用较A组明显减少(P<0.01或P<0.05)。结论联合L-Arg和腺苷对婴幼儿法洛四联症根治术心肌有良好的保护作用,可以促进患儿恢复,缩短患儿住院时间,减少住院费用。Objective To investigate the myocardial protective effects of L-arginine（L-Arg）combined with adenosine applied during the radical correction of tetralogy of Fallot in infants.Methods 60 infants with tetralogy of Fallot scheduled for open heart surgery were randomly divided into four groups（n=15）：control group（group A）,L-Arg group（group B）,adenosine group（group C）and L-Arg combined with adenosine group（group D）.Group A was given conventional cold crystalloid cardioplegia,group B was given 2.5 g/L of L-Arg cardioplegia,group C was treated with 2.5 g/L of adenosine cardioplegia,and group D was given the combined cardioplegia of L-Arg and adenosine.Results There was no significant difference in automatic cardioversion rate among group A and other three groups,but the times of electrical cardioversion for non-automatic cardioversion in group D were significantly less than that in group A（P〈0.05）.Mechanical ventilation time in group D（P〈0.05）was significantly lower than that in group A,and ICU retention time in group D and B was significantly shorter than that in group A and C,respectively.The consumption of dopamine in group D was less than that in group A（P〈0.05）and was similar to that of group B and C.The hospital days in group D and B were significantly shorter than those in group A.The hospitalization cost in group A was significantly higher than that in other three groups（P〈0.01 or P〈0.05）.Conclusion The combined use of L-Arg and adenosine during the radical correction of tetralogy of Fallot in infants has good myocardial protective effects.It can promote infants＇ recovery,shorter their hospital days and reduce hospital cost.

关 键 词：婴幼儿 法洛四联症 根治术 心肌保护 

分 类 号：R541.1[医药卫生—心血管疾病]