体外循环心脏不停跳及停跳手术对SDH、S-GLDH及ALT的影响研究  

Effects of cardiac surgery under extracorporeal circulation with or without heart beating on SDH, S-GLDH, and ALT

作　　者：梁荣鑫[1] 

机构地区：[1]广东省第二人民医院,广东广州510317

出　　处：《心血管病防治知识（学术版）》2013年第6期35-37,共3页Prevention and Treatment of Cardiovascular Disease

摘　　要：目的对体外循环心脏不停跳及停跳手术对SDH、S-GLDH及ALT的影响进行研究和分析。方法选取2010年3月至2013年3月期间,我院收治的200例接受心脏手术的患者,其中男128例,女72例,年龄为1-29岁,平均年龄为(5.3±2.9)岁,体重为6-51kg,平均体重(16.9±3.7)kg;其中123例为VSD,58例为ASD,19例为PS。随机将上述患者分为观察组和对照组。观察组行体外循环心脏停跳心内直视手术,对照行体外循环心脏不停跳心内手术。结果所有患者的S-GLDH,SDH指标都在术后2小时开始上升,到术后1d达到峰值,和术前比较,差异显著(P<0.05),术后3天基本恢复正常。在术后2小时和1天两个时点,对照组患者的S-GLDH和SDH指标都显著低于观察组(P<0.05)。所有患者的ALT指标在术后2小时出现了峰值,术后3天逐渐下降。在术后2小时、1天和术后3天这几个时点,对照组患者的ALT指标明显低于观察组(P<0.05)。结论体外循环心脏不停跳手术能够有效控制对患者肝脏功能的影响,值得临床推广应用。Objective To study and analyze the effects of cardiac surgery under extracorporeal circulation with or without heart beating on sorbitol dehydrogenase （SDH）, serum glutamate dehydrogenase （S-GLDH）, and alanine aminotransferase （ALT）. Methods A total of 200 patients who underwent cardiac surgery in our hospital from March 2010 to March 2013 were included in the study. These patients, including 128 males and 72 females, had a mean age of 5.3±2.9 years （range, 1-29 years） and a mean body weight of 16.9±3.7 kg （range, 6-51 kg）. Of the 200 patients, 123 had ventricular septal defect, 58 had atrial septal defect, and 19 had pulmonary stenosis. These patients were randomly divided into observation group and control group. The observation group underwent open-heart surgery under extracorporeal circulation without heart beating, while the control group underwent open-heart surgery under extracorporeal circulation with heart beating. Results TAmong all patients, S-GLDH and SDH began to rise at 2 h after surgery and reached the peak levels at 24 h after surgery, with significant differences compared with the values before surgery （P〈0.05）. These indices were almost restored to normal at 3 d after surgery. The control group had significantly lower S-GLDH and SDH than the observation group at 2 h and 24 h after surgery （P〈0.05）. In all patients, ALT reached the peak level at 2 h after surgery and gradually decreased at 3 d after surgery. The control group had a significantly lower ALT than the observation group at 2 h, 24 h, and 3 d after surgery （P〈0.05）. Conclusion Cardiac surgery under extracorporeal circulation with heart beating can control the adverse effects on liver function in patients and holds promise for clinical application.

关 键 词：体外循环 心脏不停跳手术 停跳手术 

分 类 号：R654.1[医药卫生—外科学]