del Nido心脏停搏液在主动脉夹层手术中的心肌保护效果  

Myocardial Protective Effect of Del Nido Cardioplegia in Aortic Dissection

作　　者：刘淼淼[1] 郜扬[1] 曹先通 王雪[1] 闫炀[1] LIU Miao-miao;GAO Yang;CAO Xian-tong;WANG Xue;YAN Yang(Dept of Cardiovascular Surgery,First Affiliated Hospital of Xi'an Jiaotong University,Xi'an,Shaanxi,710007,China)

机构地区：[1]西安交通大学第一附属医院心血管外科,陕西西安710007

出　　处：《现代生物医学进展》2021年第9期1648-1651,1668,共5页Progress in Modern Biomedicine

基　　金：陕西省自然科学基金项目(2020JQ-535)。

摘　　要：目的:探讨del Nido心脏停搏液在主动脉夹层手术中的心肌保护效果.方法:2015年2月到2020年6月选择在本院进行急诊手术的StanfordA型主动脉夹层的150例患者,入院后根据术中采用的心脏停搏液的不同分为两组del Nido组与对照组各75例,所有患者都实施大血管外科手术,由同一组医师团队完成手术.Del Nido组给予del Nido心脏停博液灌注,对照组给予改良St.Thomas液灌注,记录心肌保护效果.结果:所有患者完成手术,两组的体外循环时间、停循环时间、阻断主动脉时间对比差异无统计学意义(P>0.05),del Nido组的灌注次数、总灌注时间、停博液晶体总量与对照组对比,差异有统计学意义(P<0.05).Del Nido组的机械通气时间、ICU停留时间、术后住院时间短于对照组(P<0.05).两组术后ld的血清cTnⅠ高于术前(P<0.05),del Nido组低于对照组(P<0.05).两组术后7d的院内死亡、心律失常、开胸止血、肾功能不全、肝功能不全等发生率对比差异无统计学意义(P>0.05).结论:delNido心脏停搏液在主动脉夹层手术中的能更好地发挥心肌保护效果,且不增加术后并发症的发生,减少灌注次数、总灌注时间,有利于促进患者康复.Objective: To investigate the myocardial protective effect of del Nido cardioplegia in aortic dissection surgery. Methods:A total of 150 patients with Stanford type A aortic dissection, who underwent emergency surgery in First Affiliated Hospital of Xi’an Jiaotong University from February 2015 to June 2020, were selected and equally divided into two groups: del Nido group and control group. All patients were given macrovascular surgery, and the operation was completed by the same team of doctors. The del Nido group was perfused with del Nido cardioplegia solution, and the control group was perfused with modified St. Thomas solution. The myocardial protective effect was recorded. Results: All patients were completed the operation. There were no significant differences in the extracorporeal circulation time, circulatory arrest time, and aortic occlusion time between the two groups(P>0.05). The number of perfusions,total perfusion time, and the total amount of liquid crystal in the del Nido group were significantly different from those in the control group(P<0.05). The mechanical ventilation time, ICU stay time, and postoperative hospital stay in the del Nido group were less than those in the control group(P<0.05). The levels of serum cTnⅠ 1 day after operation in the two groups were higher than those before operation(P<0.05), and the del Nido group was lower than the control group(P<0.05). There were no significant differences in the incidence of hospital death, arrhythmia, thoracotomy to stop bleeding, renal insufficiency, and liver insufficiency 7 days after operation between the two groups(P>0.05). Conclusions: Del Nido cardioplegia can better exert the myocardial protection effect in aortic dissection surgery,will not increase the occurrence of postoperative complications, can reduce the number of perfusions and total perfusion time, and promote the recovery of patients.

关 键 词：del Nido心脏停搏液 主动脉夹层 大血管外科手术 心肌保护 并发症 

分 类 号：R543.1[医药卫生—心血管疾病] R654.2[医药卫生—内科学]