参附注射液对体外循环下二尖瓣置换术患者围术期的影响  

Effects of Shenfu Injection on Postoperative Assisted Respiration andSerum sICAM-1, CK-MB and cTnI in Patients Undergoing MitralValve Replacemen with Cardiopulmonary Bypass

作　　者：宋志斌[1] 孙丹 马亚飞[1] 魏利娟[1] 王永生[1] SONG Zhi-bin;SUN Dan;MA Ya-fei;WEI Li-juan;WANG Yong-sheng(Cardiovascular Surgery,Clinical Medical College of Henan University of Science and Technology(First Affiliated Hospital of Henan University of Science and Technology),Luoyang 471003,China;Medical College of Luoyang Vocational and Technical College,Luoyang 471000,China)

机构地区：[1]河南科技大学临床医学院(河南科技大学第一附属医院)心血管外科,洛阳471003 [2]洛阳职业技术学院医学院,洛阳471000

出　　处：《中国合理用药探索》2020年第5期52-55,共4页Chinese Journal of Rational Drug Use

基　　金：河南省科技计划项目资助(172102310686)。

摘　　要：目的:探讨体外循环下二尖瓣置换术患者围术期应用参附注射液的效果。方法:选取我院2016年4月~2017年6月行体外循环下二尖瓣置换术患者78例,随机数字表法分为对照组(n=39)与研究组(n=39)。两组均采取体外循环下二尖瓣置换术,研究组术后1~4天静脉滴注参附注射液,对照组给予等量生理盐水。统计两组术后情况、术前及术后d 4时患者的心肌损伤指标与左心室射血分数(LVEF)。结果:研究组ICU停留时间、术后辅助呼吸时间短于对照组(P<0.05);术后d 4血清可溶性细胞间黏附分子-1(sICAM-1)、血清心肌肌钙蛋白I(cTnI)、血肌酸激酶同工酶(CK-MB)水平低于对照组(P<0.05);术后d 4,两组LVEF较治疗前增高,且研究组高于对照组(P<0.05)。结论:体外循环下二尖瓣置换术治疗前后联合采取参附注射液,可有效缩短ICU停留时间及术后辅助呼吸时间,抑制血清sICAM-1、CK-MB、cTnI水平大幅增高,并促使其及早恢复,且利于改善患者术后心功能。Objective:To investigate the application effect of Shenfu injection in patients of mitral valve replacement with cardiopulmonary bypass during perioperative period.Methods:A total of 78 patients undergoing mitral valve replacement with cardiopulmonary bypass in our hospital from April 2016 to June 2017 were randomly divided into the control group(n=39)and the study group(n=39).The two groups were treated with mitral valve replacement with cardiopulmonary bypass.The study group was given Shenfu through intravenous drip for 4 days after surgery,while the control group with saline.The postoperative conditions of the two groups,myocardial injury indexes and left ventricular ejection fraction(LVEF)before operation and at 4d after operation were calculated.Results:The ICU stay time and postoperative auxiliary breathing time of the study group were shorter than that of the control group(P<0.05).At 4 d,the levels of sICAM-1,cTnI and CK-MB in study group were lower than those in the control group(P<0.05).LVEF in both groups at 4d was higher than that before the treatment,and the increase in the study group was higher than that in the control group(P<0.05).Conclusion:The application of Shenfu injection in patients undergoing mitral valve replacement with cardiopulmonary bypass can effectively shorten ICU residence time and postoperative auxiliary breathing time,inhibit the increase serum levels of sICAM-1,CK-MB and cTnI,promote early recovery,and improve cardiac function of patients after operation.

关 键 词：参附注射液 体外循环下二尖瓣置换术 辅助呼吸时间 血清可溶性细胞间黏附分子-1 血肌酸激酶同工酶MB 心肌肌钙蛋白I 

分 类 号：R285.6[医药卫生—中药学]