双管加温二氧化碳吹雾管在非体外循环不停跳冠状动脉旁路移植术患者中的临床疗效  

Clinical efficacy of dual tube heated carbon dioxide mist blowing tube in patients undergoing off pump coronary artery bypass grafting with beating heart

作　　者：谭丽丽 田海娇[2] 张兰 Tan Lili;Tian Haijiao;Zhang Lan(Operating Room,Beijing Chaoyang Hospital,Capital Medical University,Beijing 100020,China;Department of Cardiac Surgery,Beijing Chaoyang Hospital,Capital Medical University,Beijing 100020,China)

机构地区：[1]首都医科大学附属北京朝阳医院手术室,北京100020 [2]首都医科大学附属北京朝阳医院心脏外科,北京100020

出　　处：《血管与腔内血管外科杂志》2024年第1期33-36,41,共5页Journal of Vascular and Endovascular Surgery

基　　金：吴阶平医学基金会临床科研专项资助基金(320.6750.19089-98)。

摘　　要：目的探讨双管加温二氧化碳吹雾管在非体外循环心脏不停跳冠状动脉旁路移植术(OPCABG)患者中的临床疗效。方法收集2020年1月至2023年1月于首都医科大学附属北京朝阳医院接受OPCABG治疗的122例患者的临床资料,按照治疗方式的不同将其分为常规组(n=61,采用常规术中吹雾管吹雾驱血技术)与加温组(n=61,采用双管加温二氧化碳吹雾管吹雾驱血技术)。比较两组患者术中吹雾管气雾温度、患者核心体温、患者术中心率变异率,统计两组患者术后恢复指标及术后并发症发生率。结果加温组患者接管2.5 min、吹雾15.0 min、吹雾30.0 min时吹雾管气雾温度均高于常规组患者;开心包即刻、吹雾3.0 min、关心包即刻、出室前加温组患者核心体温均高于常规组患者;吹雾3.0、10.0、20.0、30.0 min时,加温组患者心率变异率均低于常规组患者,差异均有统计学意义(P﹤0.05)。加温组患者抗生素使用时间、引流置管时间、呼吸机应用时间、留置动脉测压时间、术后住院时间均短于常规组患者,术后引流量低于常规组患者,差异均有统计学意义(P﹤0.05)。加温组患者术后肺感染发生率为3.28%(2/61),低于常规组患者的16.39%(10/61),差异有统计学意义(P=0.015)。结论OPCABG术中采用双管加温二氧化碳吹雾管技术能够有效减小患者术中温差变化幅度,减轻温差刺激诱发的过度心率变异率,有利于患者术后恢复,并可降低术后肺感染发生风险。Objective To investigate the clinical efficacy of dual tube heated carbon dioxide mist blowing tube in patients undergoing off pump coronary artery bypass grafting with beating heart(OPCABG).Method The clinical data of 122 patients who received OPCABG in Beijing Chaoyang Hospital,Capital Medical University from January 2020 to January 2023 were collected.According to the different treatment methods,they were divided into conventional group(n=61,given conventional intraoperative mist blowing and blood driving technology)and warming group(n=61,givening dual tube heated carbon dioxide mist blowing and blood driving technology).The changes in intraoperative aerosol temperature,core body temperature,and heart rate variability between two groups were compared,the postoperative recovery indicators and incidence of postoperative complications for both groups were calculated.Result The temperatures of the mist blowing tube in the heating group were higher than those in the control group after 2.5 min of administration,15.0 min of mist blowing,and 30.0 min of mist blowing;the core body temperature of patients in the open pericardium immediately,mist blowing 3.0 min,close pericardium immediatele,and before leaving the room in warming group were all higher than those in the conventional group;at 3.0,10.0,20.0,and 30.0 min of fogging,the heart rates variability in the warming group were lower than those of the control group,the differences were statistically significant(P﹤0.05).The antibiotic usage time,drainage tube placement time,ventilator application time,arterial pressure measurement time,and postoperative hospitalization time of the warming group were all shorter than those of the conventional group,the postoperative drainage volume was lower than that of the conventional group,the differences were statistically significant(P﹤0.05).The incidence of postoperative pulmonary infection in the warming group was 3.28%(2/61),lower than the 16.39%(10/61)of the control group,the difference was statistically significant(P=0.0

关 键 词：双管加温 二氧化碳吹雾管 非体外循环不停跳冠状动脉旁路移植术 核心体温 心率变异率 

分 类 号：R543[医药卫生—心血管疾病]