心脏瓣膜手术中HTK液与含血停搏液心肌保护效果的比较  

Comparison of Myocardial Protection between HTK Solution and Blood Cardioplegia in Cardiac Valve Surgery

作　　者：王蕾 杨立平[1] WANG Lei;YANG Liping(Department of Cardiac Surgery,Fujian Medical University Union Hospital,Fuzhou 350001,China)

机构地区：[1]福建医科大学附属协和医院心外科

出　　处：《福建医科大学学报》2019年第5期338-341,共4页Journal of Fujian Medical University

摘　　要：目的比较心脏瓣膜手术中采用HTK液与含血停搏液对心肌的保护效果。方法收集2016年3月-2018年4月行心脏瓣膜手术的50例患者的临床资料,其中25例术中采用单次灌注HTK液(HTK组),25例采用多次灌注1∶4含血停搏液(BC组),比较两组患者术前、术中及术后的相关临床指标。结果术前HTK组的心脏彩超左室后壁厚度(LVPWT)、室间隔厚度(IVST)大于BC组(P<0.01);术后第1天HTK组的血心肌型肌酸激酶同功酶(CK-MB)及肌钙蛋白I(TnI)低于BC组(P<0.01)。两组患者的术中体外循环转流时间、心脏停搏液灌注量、主动脉阻断时间、后并行时间、主动脉开放后自动复跳率、术后ICU停留时间、机械通气时间、多巴胺使用时间、术后病房住院时间等比较,差别无统计学意义(P>0.05)。HTK组的主动脉阻断时间与术后第1天CK-MB值(R=0.604,P<0.01)及TnI值(R=0.558,P<0.05)有明显相关性。结论HTK液在心脏瓣膜手术中的心肌保护效果优于含血停搏液。Objective To compare myocardial protective effects between HTK solution and blood cardioplegia in cardiac valve surgery.Methods A total of 50 cases of cardiac valve surgery were collected from March 2016 to April 2018,of which 25 cases accepting single-dose HTK solution were divided into HTK solution group(HTK group),while 25 cases accepting multiple-dose blood cardioplegia were divided into blood cardioplegia group(BC group).The preoperative,intraoperative,and postoperative clinical indicators were compared between the two groups.Results The left ventricular posterior wall thickness(LVPWT)and interventricular septal thickness(IVST)of preoperative color doppler echocardiography were greater in HTK group than BC group(P<0.01),but the value of creatine kinase MB(CK-MB)and troponin I(TnI)(P<0.01)on the first day after surgery were lower in HTK group than BC group.There were no significant differences between the two groups of cardiopulmonary in bypass time,volume of cardioplegic solution,aortic cross-clamping time,mechanical time,rate of spontaneous cardiac rhythm,postoperative ICU stay time,mechanical ventilation time,dopamine using time,and postoperative ward stay time.The aortic cross-clamping time was significantly correlated with the value of CK-MB(R=0.604,P<0.01)and TnI(R=0.558,P<0.05)on the first day after surgery in HTK group.Conclusion Myocardial protective effect of HTK solution in cardiac valve surgery is better than that of blood cardioplegia.

关 键 词：心肌 心脏瓣膜疾病 心麻痹液 

分 类 号：R916.3[医药卫生—药学] R971.2