二尖瓣置换术Del Nido停搏液与St.Thomas停搏液心肌保护比较  

Comparison of Myocardial Protection between Del Nido Cardioplegia Solution and St.Thomas Cardioplegia Solution in Mitral Valve Replacement

作　　者：岳静 周朝元[1] 韩培立[1] YUE Jing;ZHOU Chaoyuan;HAN Peili(Department of Cardiovascular Surgery,the First Affiliated Hospital of Xinxiang Medical College,Weihui 453100,China)

机构地区：[1]新乡医学院第一附属医院心血管外科,河南卫辉453100

出　　处：《医学综述》2023年第1期199-203,共5页Medical Recapitulate

摘　　要：目的比较Del Nido停搏液与St.Thomas停搏液在成人二尖瓣置换术中的心肌保护效果。方法分析2020年4月至2021年6月新乡医学院第一附属医院心血管外科收治的60例行体外循环下单纯二尖瓣置换术患者的临床资料,根据心脏停搏液的不同分为Del Nido组和St.Thomas组,每组30例。比较两组术中体外循环时间、主动脉阻断时间、心脏停搏液灌注次数以及术后心肌肌钙蛋白I(cTnI)和肌酸磷酸激酶同工酶(CK-MB)水平、多巴胺使用时间、重症监护病房住院时间、机械通气时间和心律失常发生情况。结果Del Nido组术中停搏液灌注次数、主动脉阻断时间均明显少于St.Thomas组[1.0(1.0,1.0)次比3.0(2.0,3.0)次、(88.3±9.5)min比(111.0±9.8)min](P<0.01)。但两组患者术中体外循环时间、机械通气时间以及术后重症监护病房住院时间、多巴胺使用时间、cTnI水平、CK-MB水平比较差异均无统计学意义(P>0.05)。Del Nido组术后心律失常发生率低于St.Thomas.Thomas组[3.3%(1/30)比23.3%(7/30)](P<0.05)。结论在成人二尖瓣置换术中,与St.Thomas停搏液相比,Del Nido停搏液灌注次数更少、主动脉阻断时间更短、术后心律失常发生率更低。Objective To compare the myocardial protection effect of Del Nido and St.Thomas cardioplegia solution in adult mitral valve replacement.Methods The clinical data of 60 patients with simple mitral valve replacement under cardiopulmonary bypass admitted to the Department of Cardiovascular Surgery of the First Affiliated Hospital of Xinxiang Medical College from Apr.2020 to Jun.2021 was analyzed.According to the different cardioplegic solutions,they were divided into a Del Nido group and a St Thomas group,30 cases in each group.The time of extracorporeal circulation,the time of aortic occlusion,the times of cardioplegia perfusion,the levels of cardiac troponin I(cTnI)and creatine phosphokinase isoenzyme(CK-MB),the time of dopamine use,the time of hospitalization in the intensive care unit(ICU),the time of mechanical ventilation and the occurrence of arrhythmia were compared between the two groups.Results The number of cardioplegia perfusion and aortic occlusion time during operation in the Del Nido group were significantly less than those in the St.Thomas group[1.0(1.0,1.0)times vs 3.0(2.0,3.0)times and(88.3±9.5)min vs(111.0±9.8)min](P<0.01).However,there was no significant difference between the two groups in the time of cardiopulmonary bypass,the time of mechanical ventilation,the time of hospitalization in the ICU,the time of dopamine use,the level of cTnI,and the level of CK-MB(P>0.05).The incidence of postoperative arrhythmia in the Del Nido group was lower than that in the St.Thomas.Thomas group[3.3%(1/30)vs 23.3%(7/30)](P<0.05).Conclusion In adult mitral valve replacement,compared with St.Thomas cardioplegia solution,Del Nido cardioplegia solution has fewer perfusion times,shorter aortic occlusion time and lower incidence of postoperative arrhythmia.

关 键 词：瓣膜手术 心肌保护 心脏停搏 Del Nido停搏液 St.Thomas停搏液 

分 类 号：R654.1[医药卫生—外科学]