含胰岛素的心肌保护液在体外循环下心脏瓣膜置换术患者中的应用效果  

Application Effect of Insulin-Containing Myocardial Protective Solution in Patients with Cardiac Valve Replacement Under Cardiopulmonary Bypass

作　　者：尹茂英 庞勇[1] YIN Maoying;PANG Yong(Department of Anesthesiology,the Affiliated Hospital of North Sichuan Medical College,Nanchong 637000,China)

机构地区：[1]川北医学院附属医院麻醉科,四川南充637000

出　　处：《临床医学工程》2024年第2期207-208,共2页Clinical Medicine & Engineering

摘　　要：目的 探讨含胰岛素的心肌保护液在体外循环下心脏瓣膜置换术患者中的应用效果。方法 93例接受体外循环下心脏瓣膜置换术治疗的患者根据使用心肌保护液的不同分为两组,对照组使用不含胰岛素的改良托马斯停跳液,研究组使用含胰岛素的改良托马斯停跳液,比较两组的体外循环停机后多巴胺用量、心肌指标以及并发症。结果 研究组体外循环停机后的多巴胺用量低于对照组,体外循环结束时、体外循环停机后24 h的cTnⅠ、 CK-MB水平均低于对照组,体外循环停机后48 h的CKMB水平低于对照组(P <0.05)。研究组的并发症总发生率为13.04%,低于对照组的29.79%(P <0.05)。结论 含胰岛素的心肌保护液用于体外循环下心脏瓣膜置换术患者可发挥较好的心肌保护作用,能有效减少血管活性药物用量,减少并发症的发生。Objective To explore the application effect of insulin-containing myocardial protective solution in patients with cardiac valve replacement under cardiopulmonary bypass.Methods 93 patients who were treated with cardiac valve replacement under cardiopulmonary bypass were divided into two groups according to different use of myocardial protective fluid.The control group received modified Thomas cardioplegia without insulin,and the study group received insulin-containing modified Thomas cardioplegia.The dosage of dopamine after cardiopulmonary bypass shutdown,myocardial indicators and complications were compared between the two groups.Results The dosage of dopamine after cardiopulmonary bypass shutdown in the study group was lower than that in the control group,the levels of cTnⅠand CK-MB at the end of cardiopulmonary bypass and 24 h after cardiopulmonary bypass shutdown were lower than those in the control group,and the level of CK-MB at 48 h after cardiopulmonary bypass shutdown was lower than that in the control group(P <0.05).The total incidence of complications in the study group was 13.04%,lower than 29.79% in the control group(P <0.05).Conclusions Insulin-containing myocardial protective solution applied in patients with cardiac valve replacement under cardiopulmonary bypass can provide good myocardial protection,effectively reduce the dosage of vasoactive drugs and reduce the occurrence of complications.

关 键 词：胰岛素 体外循环 心脏瓣膜置换术 心肌保护液 

分 类 号：R654.1[医药卫生—外科学]