体外循环冠状动脉搭桥术中采用不同停跳液灌注的心肌保护作用研究  

Myocardial protective effects of different cardioplegia infusion during coronary artery bypass grafting

作　　者：林霞[1] 应晓珍[2] LIN Xia;YING Xiao-zhen(Department of Thoracic Surgery, Lishui Central Hospital, Lishui 323000, China;Department of Radiation Oncology, Lishui Central Hospital, Lishui 323000, China)

机构地区：[1]丽水市中心医院胸外科,浙江丽水323000 [2]丽水市中心医院放疗科,浙江丽水323000

出　　处：《中国生化药物杂志》2017年第11期202-203,共2页Chinese Journal of Biochemical Pharmaceutics

摘　　要：目的探讨体外循环下冠状动脉搭桥手术中不同停跳液灌注的心肌保护作用。方法选取丽水市中心医院2015年2月～2017年4月收治的88例冠心病患者，均接受体外循环冠状动脉搭桥手术治疗，根据患者选择灌注的不停跳液不同均分为冷晶体组（n=44）和含血组（n=44）。冷晶体组患者给予冷晶体不停跳液灌注，含血组患者给予含血不停跳液灌注，记录并比较2组患者手术前、主动脉开放后即刻、术后6h、术后12h、术后1d、术后2d的CK-MB检测值。结果术中2组主动脉开放后即刻至术后12hCK-MB水平均呈上升趋势，至术后1d之后CK-MB水平则逐渐降低（P＜0.05），但2组各时间段CK-MB检测结果对比差异无统计学意义。结论不同停跳液对体外循环冠状动脉搭桥术患者心肌保护作用相近，但冷晶体停跳液性价比更高。Objective To investigate the myocardial protection of coronary artery bypass grafting under cardiopulmonary bypass(CPB).Methods88patients with coronary heart disease from February2015to April2017were selected and underwent off-pump coronary artery bypass surgery,patients were divided into cold crystalloid group(n=44)and blood group(n=44)according to patient choosing different cardioplegia perfusion cardioplegia perfusion.Cold crystalloid group were treated with cold crystalloid cardioplegia perfusion,blood group were treated with blood cardioplegia perfusion.CK-MB detection value before surgery,immediately after aorta opening,postoperative6hs,12hs,1day after surgery,postoperative2days in two groups were recorded and compared.Results CK-MB level after aortic opening to the immediate postoperative12h intwo groups showed an upward trend,and after the postoperative1day decreased gradually(P0.05),but there was no significant difference between the two groups at the same.Conclusion The myocardial protective effects of different cardioplegic solutions on coronary artery bypass grafting are similar,but cold crystalloid cardioplegia is more economics for patients.

关 键 词：体外循环冠状动脉搭桥术 停跳液 冷晶体 含血 心肌保护 

分 类 号：R655[医药卫生—外科学]