硝酸甘油对鱼精蛋白中和肝素前后肺静脉血流频谱的影响  

Effect of nitroglycerin on pulmonary venous flow pectrum before and after the neutralization of heparin with protamine.

作　　者：王丽[1] 李书平[2] 

机构地区：[1]宜宾市第一人民医院麻醉科,四川宜宾644000 [2]宜宾市第一人民医院胸外科,四川宜宾644000

出　　处：《海南医学》2012年第21期23-26,共4页Hainan Medical Journal

摘　　要：目的探讨鱼精蛋白中和肝素抗凝过程中硝酸甘油对鱼精蛋白肺静脉血流频谱的影响。方法采用随机双盲对照试验,将40例择期行体外循环心脏瓣膜置换手术的患者分为实验组及对照组各20例,利用术中经食道超声心动图(TEE)测量体外循环(CPB)结束后两组患者鱼精蛋白中和肝素抗凝前后肺静脉血流频谱的变化。结果实验组肺静脉血流S波和D波,在鱼精蛋白推注后即刻及5min明显高于对照组(P<0.05),与鱼精蛋白注入前比较差异无统计学意义(P>0.05)。对照组S波和D波在鱼精蛋白注入后即刻和5min明显降低(P<0.05)。20min后两组S波和D波基本一致(P>0.05)。结论硝酸甘油预防性使用有利于增加鱼精蛋白中和肝素过程中的肺血流,预防和减少肺血管痉挛,维护血液动力学稳定,保护心功能,减少鱼精蛋白反应。Objective To investigate the effect of nitroglycerin on pulmonary venous flow spectrum （PVFS） during the neutralization of heparin with protamine. Methods All the patients were divided into nitroglycerin （N group, n=20） and saline group （S group, n=20）. The changes of PVFS were measured by TEE before and after neutralization. Results Wave S and D in N group was significantly higher than S group immediately and 5 min after neutralization （P0.05）. And they were no significant difference before and after protamine injection in N group. Wave S and D in S group were significantly decreased immediately and 5 min after protamine injection （P0.05）. Wave S and D were the same in 20 min administration. Conclusion The prophylactic use of nitroglycerin was helpful to increase the pulmonary blood flow in the process of protamine-heparin neutralization, prevent and reduce pulmonary vascular spasm, maintain the hemodynamic stability and protect heart function, and reduce protamine reaction.

关 键 词：经食道超声心动图 硝酸甘油 鱼精蛋白反应 肺血流频谱 

分 类 号：R543.2[医药卫生—心血管疾病]