康斯特保护液与冷含血停搏液对重症心脏瓣膜置换术心肌保护作用的比较  

Comparison of myocardial protection effect of HTK with cold blood cardioplegia on severe valvular heart disease

作　　者：杨超[1] 池繁武 杜静[2] 彭彬 周钧 王威 温定国 

机构地区：[1]暨南大学第二临床医学院( 深圳市人民医院)心脏外科,广东深圳518020 [2]北京大学深圳医院,518049

出　　处：《安徽医学》2014年第5期655-658,共4页Anhui Medical Journal

摘　　要：目的比较康斯特保护液(HTK液)、冷含血停搏液(CBC液)在重症心脏瓣膜(SVHD)置换手术中的心肌保护效果。方法 40例成人SVHD手术患者随机分为两组:HTK液组(n=20)、CBC停搏液组(n=20)。测定围术期6个时点的血清cTnI、CK-MB水平。比较两组心脏自动复跳率、术后多巴胺用量、机械通气时间、ICU滞留时间。结果两组患者升主动脉阻断后血清中cTnI、CK-MB浓度均明显升高。升主动脉阻断后10 min、升主动脉开放后30 min、术后6 h HTK组cTnI、CKMB明显低于CBC组。HTK组心脏自动复跳率远高于CBC组。术后多巴胺用量、呼吸机辅助呼吸时间及ICU停留时间HTK组明显少于CBC组。结论 HTK心脏停搏液对SVHD手术患者的心肌保护作用优于4:1CBC液。Objective To compare the myocardial protective effect of Histidine-tryptophan-ketoglutarate( HTK) solution with cold blood cardioplegia( CBC) on severe valvular heart disease( SVHD). Methods Forty patients with SVHD were divided randomly into two groups: HTK group( n = 20) and 4: 1 CBC group( n = 20). CK-MB and cTnI of serum were measured respectively at 6 different time points perioperatively. The ratio of auto beating,inotropic drug( dopamine) dosage,duration of mechanical ventilation and ICU stay time were compared between the two groups. Results The concentration of serum cTnI and CK-MB increased obviously after aorta clamping in both groups. The plasma cTnI and CK-MB levels in HTK group were remarkably lower at 3 time points( 10 mins after aorta clamping,30 mins after aortic decalmping and 6h postoperatively) than those in CBC group. The auto beating ratio was significantly higher in HTK group than that in CBC group. The dopamine dosage,mechanical ventilation support time and ICU stay time were significantly lower in HTK group than those in CBC group. Conclusion HTK solution exhibits higher value of myocardial protection for SVHD than 4: 1 CBC.

关 键 词：康斯特液 冷含血停搏液 重症心脏瓣膜疾病 心肌保护 

分 类 号：R654.2[医药卫生—外科学]