不停跳心脏手术围术期血液流变学变化  

The changes of hemorrheology at beating open-heart surgery patients undergoing cardiopulmonary bypass.

作　　者：向道康[1] 李正伦[1] 阎兴治[1] 杨世虞[1] 张大国[1] 

机构地区：[1]贵州省人民医院心外科,贵阳550002

出　　处：《贵州医药》2002年第5期405-406,共2页Guizhou Medical Journal

基　　金：贵州省优秀科技人才省长专项基金资助项目 (2 0 0 1年第 4号 )

摘　　要：目的观察不停跳心内直视手术患者血液流变学及颈内静脉血中S 10 0 β蛋白的变化 ,以探讨血液流变学变化与神经元损伤的关系。方法 2 9例风湿性心脏瓣膜疾病患者 ,在体外循环(CPB)心脏跳动下进行瓣膜替换术 ,动态监测围术期所有患者颈内静脉血中S 10 0 β蛋白及血液流变学指标 :全血粘度 (CP)、红细胞压积 (HCT)、血小板聚集率 (PCR)的水平变化 ,并探讨二者的相关关系。结果从转流 2 0分钟到术后 8小时 ,患者CP、HCT、PCR均明显低于术前 (P <0 0 5或P <0 0 1) ,术后 1天恢复至术前水平 ;S 10 0 β蛋白水平则明显高于术前 (P <0 0 5或P <0 0 1) ,术后 3天恢复至术前水平 ,且与上述血液流变学指标存在明显的相关关系。结论颈内静脉血中S 10 0 β蛋白水平变化虽可作为评价心内直视手术对神经元损伤程度的可靠指标 ,但检测经费昂贵 ;而S 10 0 β蛋白与血液流变学指标的变化有明显的相关性。故心脏不停跳心内直视手术患者 ,评价其手术对神经元的损伤程度 ,监测血液流变学的变化是一项简便、价廉、有效的措施。Objective To investigate the changes of hemorrheology at beating open heart surgery patients and assessment its clinical values.Methods 29 cases open heart surgery with cardiopulmonary bypass(CPB) were studied in this article.The protein S 100β and the parameters of hemorrheology were monitored during perioperative period.Results The Changes of the protein S 100β and the parameters of hemorrheology from CPB 20 minutes to 1d postoperation were different significantly than before operation( P <0.05 or P <0 01),there has a significantly correlation coefficient in both of them.Conclusion The analysis of protein S 100β might allow insight into the underlying neurophychiatric deficits of neuronal injury and it has a significantly correlation coefficient with the hemorrheology,to monitor neurophychiatric deficits of neuronal injury at beating open heart surgery patients,the hemorrheology is a valuable tool.

关 键 词：心内直视手术 跳动心脏 血液流变学 神经元损伤 

分 类 号：R654.2[医药卫生—外科学]