左西孟旦治疗冠脉搭桥术围术期重症冠心病患者的临床疗效  

Clinical efficacy of levosimendan in the perioperative period of coronary artery bypass grafting of patients with severe coronary heart disease

作　　者：聂森 NIE Sen(Comprehensive Internal Medicine Ward,Tieling Central Hospital Xincheng Branch,Tieling 112000,China)

机构地区：[1]辽宁省铁岭市中心医院新城院区综合内科病房,112000

出　　处：《中国现代药物应用》2022年第5期9-11,共3页Chinese Journal of Modern Drug Application

摘　　要：目的分析左西孟旦治疗冠脉搭桥术围术期重症冠心病患者的临床疗效。方法80例重症冠心病者,随机分为常规组与实验组,各40例。两组均于麻醉诱导后进行冠脉搭桥术,实验组患者接受左西孟旦静脉给药,常规组患者静脉泵入0.9%氯化钠溶液。对比实验组用药前后基本体征变化情况,并比较两组预后情况、手术前后生化指数及血流动力学变化情况。结果实验组术后48 h主动脉内球囊反搏(IABP)使用率5.00%及术后房颤率10.00%,均低于常规组的32.50%、40.00%,差异有统计学意义(P<0.05)。实验组用药前与用药6 h(P1)、用药12 h(P2)时心率(HR)、中心静脉压(CVP)、收缩压(SBP)、舒张压(DBP)对比,差异无统计学意义(P>0.05)。T1(术后12 h)、T2(术后48 h)时,实验组氨基末端脑钠肽前体(NT-proBNP)、外周血管阻力(SVR)、肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白I(cTnI)水平均优于常规组,差异均有统计学意义(P<0.05)。结论左西孟旦应用于冠脉搭桥术围术期可改善重症冠心病者心功能表现,使用安全,值得推广。Objective To analyze the clinical efficacy of levosimendan in the perioperative period of coronary artery bypass grafting of patients with severe coronary heart disease.Methods A total of 80 patients with severe coronary heart disease were randomly divided into conventional group and experimental group,with 40 cases in each group.Both groups underwent coronary artery bypass grafting after anesthesia induction.The experimental group received levosimendan intravenously,and the conventional group received intravenous infusion of 0.9% sodium chloride solution.Comparison was made on changes of basic physical signs before and after treatment in the experimental group,and the prognosis,the changes of biochemical indexes and hemodynamics before and after surgery between the two groups.Results The use rate of intra-aortic balloon counterpulsation(IABP)at 48 h after surgery in the experimental group was 5.00% and the rate of postoperative atrial fibrillation was 10.00%,which were lower than 32.50% and 40.00% in the conventional group,and the differences were statistically significant(P<0.05).The heart rate(HR),central venous pressure(CVP),systolic blood pressure(SBP)and diastolic blood pressure(DBP)in the experimental group at 6 h(P1)and 12 h(P2)after medication were not statistically significant(P>0.05)compared with those before medication.At 12 h after surgery(T1)and 48 h after surgery(T2),the N-terminal pro-brain natriuretic peptide(NT-proBNP),systemic vascular resistance(SVR),creatine kinase isoenzyme(CK-MB),cardiac troponin I(cTnI)was better than that of the conventional group,and the difference was statistically significant(P<0.05).Conclusion The application of levosimendan in the perioperative period of coronary artery bypass grafting can improve the cardiac function performance of patients with severe coronary heart disease.It is safe to use and worthy of promotion.

关 键 词：重症冠心病 冠脉搭桥术 围术期 左西孟旦 

分 类 号：R654.2[医药卫生—外科学]