Del Nido停搏液与HTK在老年心脏瓣膜手术中的心肌保护效果比较  

Myocardial protection of Del Nido cardioplegia and HTK in elderly heart valve surgery

作　　者：门琛[1] 邵永丰 马路遥 黄浩斌 郑翔翔 MEN Chen;SHAO Yongfeng;MA Luyao;HUANG Haobin;ZHENG Xiangxiang(Department of Geriatrics,the First Affiliated Hospital of Nanjing Medical University,Nanjing,Jiangsu 210029,China;Department of Cardiovascular Surgery,the First Affiliated Hospital of Nanjing Medical University,Nanjing,Jiangsu 210029,China)

机构地区：[1]南京医科大学第一附属医院老年科,江苏南京210029 [2]南京医科大学第一附属医院心脏大血管外科,江苏南京210029

出　　处：《医药前沿》2021年第36期17-19,共3页Journal of Frontiers of Medicine

基　　金：江苏省研究生教育教学研究与实践课题(JGLX19-079)。

摘　　要：目的:比较Del Nido心脏停搏液与组氨酸-色氨酸-酮戊二酸液(histidine-tryptophan-ketoglutarate solution,HTK)停搏液在老年心脏手术中的心肌保护效果。方法:选取2019年1月—2021年1月在南京医科大学第一附属医院行体外循环(CPB)下心脏直视手术的100例年龄>70岁的老年患者。使用国产心肌保护液为HTK组(n=50);使用del Nido停搏液的为DN组(n=50)。记录并比较两组患者CPB时间、主动脉阻断时间、除颤率、术后血清肌钙蛋白T(cTnT)水平、术后气管插管时间、术后住院时间、术后射血分数(EF)等临床资料。结果:两组患者CPB时间、主动脉阻断时间、血液指标、术后cTnT水平、呼吸机使用时间、术后住院天数比较,差异均无统计学意义(P>0.05)。干预后,DN组心脏复跳后心脏除颤率显著低于HTK组,差异有统计学意义(P<0.05)。干预后,DN组治疗费用显著低于HTK组,差异有统计学意义(P<0.05)。结论:使用DN停搏液具有与HTK停搏液相同的临床效果。DN停搏液在老年心脏瓣膜手术中的应用是安全、经济、可行的。Objective To compare the myocardial protective effects of del Nido cardioplegia solution and HTK cardioplegia solution in elderly cardiac surgery.Methods 100 elderly patients over 70 years old who underwent open heart surgery under cardiopulmonary bypass(CPB)in the First Affiliated Hospital of Nanjing Medical University from January 2019 to January 2021 were selected.Domestic myocardial protective solution was used as HTK group(n=50);DN group(n=50)used del Nido cardioplegia.CPB time,aortic occlusion time,defibrillation rate,postoperative serum troponin T(cTnT)level,postoperative endotracheal intubation time,postoperative hospital stay,postoperative ejection fraction(EF)and other clinical data were recorded and compared between the two groups.Results There was no significant difference in CPB time,aortic occlusion time,blood indexes,postoperative cTnT level,ventilator use time and postoperative hospital stay between the two groups(P>0.05).After the intervention,the defibrillation rate in DN group was significantly lower than that in HTK group(P<0.05).After the intervention,the treatment cost of DN group was significantly lower than that of HTK group(P<0.05).Conclusion DN cardioplegia has the same clinical effect as HTK cardioplegia.The application of DN cardioplegia in elderly heart valve surgery is safe,economical and feasible.

关 键 词：HTK液 Del Nido停搏液 心肌保护 老年心脏瓣膜病 体外循环 

分 类 号：R541[医药卫生—心血管疾病]