两种长效心肌保护液对成人体外循环心脏手术心肌保护的影响  

The effect of two long-term cardioplegia on myocardial protection during adult cardiac surgery with cardiopulmonary bypass

作　　者：李子林 胡静[3] 段旭杰 李梦妍 金振晓 陈涛 Li Zilin;Hu Jing;Duan Xujie;Li Mengyan;Jin Zhenxiao;Chen Tao(Department of Cardiovascular Surgery,The First Affiliated Hospital of Air Force Medical University,Shannxi Xi’an 710032,China)

机构地区：[1]空军军医大学第一附属医院心血管外科,西安710032 [2]空军第986医院心胸外科,西安710054 [3]西北大学生命科学与医学院,西安710069

出　　处：《中国体外循环杂志》2024年第5期360-364,共5页Chinese Journal of Extracorporeal Circulation

基　　金：国家自然科学基金(81400276)。

摘　　要：目的回顾性比较两种长效心肌保护液(del Nido液和HTK液)在成人体外循环心脏手术中的心肌保护效果。方法本研究纳入2022年2月至2023年2月空军军医大学第一附属医院体外循环下成人心脏手术105例,根据所使用的心肌保护液的不同分为两组:del Nido(DN)组(55例)和HTK组(50例),对患者相关临床数据、围手术期特定时间点相关临床指标给予评估。结果两组在体外循环时间、主动脉阻断时间、术中尿量等方面均无统计学差异(P>0.05);术后左室射血分数和左室舒张末内径无显著性差异(P>0.05),术后血液检验指标中肌酸激酶-MB亚型、肌钙蛋白I、B型钠尿肽、丙氨酸氨基转移酶、天门冬氨酸氨基转移酶、总胆红素、肌酐、尿素及乳酸均无统计学差异(P>0.05)。但DN组的心肌灌注量及超滤液量少于HTK组(P<0.01),而灌注次数则多于HTK组。结论在成人心脏手术中del Nido液与HTK液均具有良好的心肌保护效果。Objective Retrospective comparison was conducted to evaluate the myocardial protective effects of del Nido solution and HTK solution in adult cardiopulmonary bypass cardiac surgery.Methods This study included 105 adult cardiac surgeries under extracorporeal circulation at the First Affiliated Hospital of Air Force Military Medical University from February 2022 to February 2023.The patients were divided into two groups based on the different myocardial protective fluids used:the del Nido(DN)group(55 cases)and the HTK group(50 cases).Clinical data related to patients and clinical indicators related to specific time points in perioperative period were evaluated.Results There was no statistical difference between the two groups in terms of extracorporeal circulation time,aortic occlusion time,and intraoperative urine volume(P>0.05).There was also no significant difference in left ventricular ejection fraction and left ventricular end-diastolic internal diameter(P>0.05).There was no statistical difference between the two groups in the blood test indexes of B-type natriuretic peptide(BNP),alanine transaminase(ALT),aspartate transaminase(AST),total bilirubin,creatinine,urea and lactic acid(Lac)(P>0.05).The DN group showed significantly lower myocardial perfusion and ultrafiltration volume compared to the HTK group(P<0.01).The DN group had more perfusion times than in the HTK group.Conclusion In adult cardiac surgery,del Nido solution exhibits excellent myocardial protective effects comparable to HTK solution.

关 键 词：Del Nido液 HTK液 心肌保护 体外循环 心脏手术 

分 类 号：R654.2[医药卫生—外科学]