体外循环下三尖瓣置换术后患者预防性使用胃肠动力药的疗效观察  

Observation of the prophylactic use of prokinetic agents in patients after tricuspid valve replacement under cardiopulmonary bypass

作　　者：陈乾 徐向阳 陆方林 韩林 李白翎 徐志云 CHEN Qian;XU Xiangyang;LU Fanglin;HAN Lin;LI Bailing;XU Zhiyun(Department of Cardio-thoracic Surgery,No.904 Hospital of Joint Logistic Support Force,Wuxi 214000,China;Department of Cardiovascular Surgery,the First Affiliated Hospital of Naval Medical University,Shanghai 200433,China)

机构地区：[1]联勤保障部队第904医院心胸外科,江苏无锡214000 [2]海军军医大学第一附属医院心血管外科,上海200433

出　　处：《药学实践与服务》2024年第3期131-134,共4页Journal of Pharmaceutical Practice and Service

基　　金：国家自然科学基金面上项目(81870287);重点攻关项目(2019YSL003)。

摘　　要：目的对体外循环下行三尖瓣置换术后患者服用胃肠动力药的治疗效果进行临床分析。方法选取2010年6月至2021年12月在海军军医大学第一附属医院心血管外科接受体外循环下三尖瓣置换术的患者作为研究对象,收集并回顾性分析术后3 d内,服用胃肠动力药(预防组)与未服用胃肠动力药(对照组)患者的基线资料、术后首次排便时间和术后恢复情况。结果筛选患者184例,其中,预防组101例,对照组83例。预防组患者首次排便时间明显早于对照组患者排便时间(P<0.05),预防组患者腹胀、肺部感染的概率明显低于对照组患者,且预防组患者ICU时长、术后机械通气时长、胃管置入时长明显短于对照组患者(P<0.05)。结论术后3 d内服用胃肠动力药能有效改善体外循环下三尖瓣置换术患者预后。Objective To analyze the postoperative therapeutic effect of prokinetic agents in patients after tricuspid valve replacement(TVR)under cardiopulmonary bypass.Methods Patients received TVR under cardiopulmonary bypass(during June 2010 to December 2021)in the department of Cardiovascular Surgery of the First Affiliated Hospital of Naval Medical University were selected as the subjects of our study.The data of basic characteristics,first postoperative defecation time and postoperative recovery condition were collected and retrospectively analyzed in the patients taking prokinetic agents within three days after surgery(prevention group)and patients not taking prokinetic agents within three days after surgery(control group).Results A total of 184 patients were selected,including 101 in the prevention group and 83 in the control group.The first defecation time of patients in the prevention group was significantly earlier than that in the control group(P<0.05).The incidences of abdominal distension and pulmonary infection in the prevention group were significantly lower than that in the control group.The length of time in ICU,postoperative mechanical ventilation and nasogastric tube decompression in the prevention group were significantly shorter than that in the control group(P<0.05).Conclusion Taking prokinetic agents within three days after TVR under cardiopulmonary bypass could effectively improve the prognosis of patients.

关 键 词：胃肠动力药 三尖瓣置换术 临床疗效 回顾性研究 

分 类 号：R654.2[医药卫生—外科学]