心脏瓣膜置换术后重度低心排综合征临床治疗  

The clinical study of cardiac valve replacement postoperative accompanying low cardiac output syndrome with vascular paralysis

作　　者：牛新荣[1] 陈东[1] 

机构地区：[1]新疆维吾尔自治区人民医院重症医学二科,830001

出　　处：《心肺血管病杂志》2017年第3期211-213,共3页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:探讨心脏瓣膜置换术后低心排综合征(LCOS)伴血管麻痹的病理生理机制。方法:通过研究40例LCOS的患者,根据PICCO监测,外周血管阻力低下的20例视为实验组,剩余20例为对照组;借助于术前、术中、术后相关监测指标来分析LCOS患者外周血管阻力低下的原因。结果:两组在心胸比、左心室射血分数、脑钠肽,体外循环时间、主动脉阻断时间、心脏指数、外周血阻力、肿瘤坏死因子、白介素-6(IL-6)、IL-8、降钙素原、C-反应蛋白差异上有统计学意义(P<0.05)。结论:实验组患者术前心脏大、心功能差,术中体外循环时间及主动脉阻断时间长,在一定程度上增加了体外循环的不良事件,术后炎症因子大量释放,导致心肌功能受损及外周血管阻力低下。Objective：To explore the pathophysiological mechanism of heart valve replacement postop erative accompanying low cardiac output syndrome（LCOS） with vascular paralysis. Methods： through the study of 40 cases of LCOS patients, according to PICCO monitoring, 20 cases of peripheral vascular resistance low re- garded as the experimental group, the remaining 20 cases as the control group. With the aid of in preoperative, intraoperafive and postoperative monitoring indicators to analyze the LCOS in patients with peripheral vascular resistance is low. Results：Two groups have significant difference in cardiothoracic ratio, LVEF, BNP, cardiop- ulmonary bypass time, aortic clamping time; moreover others have significant difference in CI and SVR; the last statistical difference is in TNF, IL-6, IL-8, PCT and CRP. Conclusion ： Patients in experimental group be- cause of the big heart, low heart function, longer intraoperative extracorporeal circulation time and aortic clam- ping time, in a certain extent, increased adverse events of cardiopulmonary bypass, which release a lot of inflammatory factors and lead to severe inflammation, so as to not only damage the cardiac function but also de- crease vascular paralysis.

关 键 词：心脏瓣膜置换术后 低心排综合征 血管麻痹 

分 类 号：R54[医药卫生—心血管疾病]