HTK液不同灌注方法对心脏瓣膜手术的心肌保护作用分析  

The Myocardial Protective Effect of Different Perfusion Methods of HTK Solution on Heart Valve Surgery

作　　者：庄严 ZHUANG Yan(Cardiovascular Surgery,the Central Hospital of Jiamusi City,Heilongjiang Province 154002)

机构地区：[1]黑龙江省佳木斯市中心医院心脏血管外科,154002

出　　处：《医学理论与实践》2021年第11期1801-1803,1806,共4页The Journal of Medical Theory and Practice

摘　　要：目的:探讨与分析HTK液不同灌注方法对心脏瓣膜手术的心肌保护作用。方法:选择2015年9月—2020年8月本院ICU收治的92例三尖瓣病变患者作为研究对象,根据随机信封抽签原则将92例患者分为HTK组与对照组,每组46例。两组分别给予心脏瓣膜手术,HTK组持续单次灌注HTK液,对照组多次灌注1∶4含血心肌保护液,记录患者的心肌功能变化情况。结果:两组患者围术期均无死亡,两组手术时间、术中出血量、ICU滞留时间、呼吸机使用时间、体外循环时间与主动脉阻断时间等对比差异无统计学意义(P>0.05)。两组术后7d的RAD与RVD值都低于术前1d(P<0.05),HTK组低于对照组(P<0.05)。两组术后7d的血清CK-MB和cTnⅠ值都低于术前1d(P<0.05),HTK组低于对照组(P<0.05)。HTK组术后3个月肺部感染、低心排血量综合征、恶性心律失常、心力衰竭等并发症总发生率低于对照组(P<0.05)。结论:HTK液单次灌注方法在心脏瓣膜手术中可以更好发挥心肌保护作用,促进患者心功能的恢复,且不影响手术进程,减少术后并发症的发生。Objective:To investigate the myocardial protective effect of different perfusion methods of HTK solution for heart valve surgery.Methods:From September 2015 to August 2020,92 cases with tricuspid valve disease diagnosed and treated in the ICU of our hospital were selected.All the cases were divided into HTK group and control group according to the principle of random envelope drawing.The two groups were given heart valve surgery.The HTK group were continuously perfused with HTK solution once,and the control group were perfused with 1∶4 blood-containing myocardial protective solution with multiple times.The changes in the patient’s myocardial function were recorded.Results:There were no death in the two groups during the perioperative period.There were no statistically significant difference compared between the two groups in operation time,intraoperative blood loss,ICU retention time,ventilator use time,extracorporeal circulation time and aortic block time(P>0.05).The RAD and RVD values of the two groups at 7 days after surgery were lower than that of the preoperative 1 day(P<0.05),and the HTK group were also lower than the control group(P<0.05).The serum CK-MB and cTnⅠvalues of the two groups at 7 days after surgery were lower than that of the preoperative 1 day(P<0.05),and the HTK group were also lower than the control group(P<0.05).The incidence of complications such as lung infection,low cardiac output syndrome,malignant arrhythmia,and heart failure in the HTK group at 3 months after operation were 4.3%,which were lower than 26.1%in the control group(P<0.05).Conclusion:The application of once infusion of HTK solution in tricuspid valve surgery can better play the role of myocardial protection,can promote the recovery of patients’heart function,and will not affect the operation process,thereby reducing the occurrence of postoperative complications.

关 键 词：HTK液 单次灌注 心脏瓣膜手术 心肌保护作用 并发症 

分 类 号：R654.2[医药卫生—外科学]