负平衡液体管理在瓣膜置换术体外循环中的应用效果  

Application effect of sub-zero balance fluid management in cardiopulmonary bypass of valve replacement

作　　者：布再尼甫·阿布都卡迪尔 黄陈红[1] 张郁林[1] Buzainifu·ABUDUKADIER;HUANG Chenhong;ZHANG Yulin(Thoracic and Cardiovascular Surgery Department,the People's Hospital of China Three Gorges University/the First People's Hospital of Yichang,Yichang 443000,China)

机构地区：[1]三峡大学人民医院/宜昌市第一人民医院胸心血管外科,湖北宜昌443000

出　　处：《临床医学研究与实践》2022年第6期92-94,共3页Clinical Research and Practice

摘　　要：目的探讨负平衡液体管理在瓣膜置换术体外循环(CPB)中的应用效果及对患者术后早期恢复的影响。方法选取2019年1月至2020年1月我科收治的60例心脏瓣膜病患者作为研究对象,根据随机数字表法将其分为A组(30例,负平衡液体管理)与B组(30例,平衡或适当正平衡液体管理)。比较两组患者的临床效果。结果两组的升主动脉阻断时间、CPB转机时间、最低鼻咽温度比较,差异无统计学意义(P>0.05)。T4、T5时,两组的COP高于T1,且A组高于B组(P<0.05);T3~T5时,两组的Lac水平均高于T1时(P<0.05);B组T5时的Lac水平高于A组(P<0.05)。A组的术后机械通气时间、术后住院时间均短于B组,CBP停机时Hct高于B组(P<0.05);两组的ICU停留时间比较,差异无统计学意义(P>0.05)。结论瓣膜置换术CPB中,在保证有效血流动力学及一定的组织灌注压的前提下,适当的负平衡液体管理能清除患者体内多余的水分,浓缩血液,有效减轻心脏负荷,利于患者术后早期恢复。Objective To explore the application effect of sub-zero balance fluid management in cardiopulmonary bypass(CPB) of valve replacement and its influence on early postoperative recovery.Methods A total of 60 patients with heart valve disease treated in our department from January 2019 to January 2020 were selected as the research objects.The patients were divided into group A(30 cases,sub-zero balance fluid management) and group B(30 cases,balanced or appropriate positive balance liquid management) according to the random number table method.The clinical effects of the two groups were compared.Results There were no significant differences in ascending aorta occlusion time,CPB transit time and minimum nasopharyngeal temperature between the two groups(P >0.05).At T4 and T5,the COP of the two groups was higher than that at T1,and that in the group A was higher than the group B(P<0.05);at T3~T5,the Lac level of the two groups was higher than that at T1(P<0.05);the Lac level at T5 in the group B was higher than that in the group A(P<0.05).The postoperative mechanical ventilation time and postoperative hospital stay in the group A were shorter than those in the group B,and Hct in CBP shutdown was higher than that in the group B(P<0.05);there was no significant difference in ICU stay time between the two groups(P >0.05).Conclusion Under the premise of ensuring effective hemodynamics and certain tissue perfusion pressure during CPB of valve replacement,proper sub-zero balance fluid management can remove excess water in patients’ bodies,concentrate blood,effectively reduce heart load and facilitate early postoperative recovery.

关 键 词：负平衡液体管理 瓣膜置换术 体外循环 

分 类 号：R654.1[医药卫生—外科学]