体外循环三种灌注方式对心肌酶的影响  

Effect of three kinds of perfusion of extracorporeal circulation on myocardial enzyme

作　　者：周易[1] 甘玉芬[1] 黄运珍[1] 缪冬梅[1] 扬淑萍[1] 

机构地区：[1]自贡市第四人民医院,四川自贡643000

出　　处：《现代医药卫生》2004年第4期240-241,共2页Journal of Modern Medicine & Health

摘　　要：目的 :比较体外循环 (CPB)晶体冷停跳液灌注、不停跳转流方式灌注和氧合血与晶体冷停跳液 (4 :1)混合灌注3种方式对临床和心肌酶的影响。方法 :ASAⅠ～Ⅱ级病例41例。分组 :A组17例为晶体冷停跳液灌注 ;B组12例为不停跳转流方式灌注 ;C组12例为氧合血与晶体冷停跳液混合灌注。麻醉诱导药为安定、氟哌啶醇、芬太尼、丙泊酚和维库溴胺 ;维持药为芬太尼和维库溴胺。各组均在术前、术后和术后36小时抽血1次查谷草转氨酶 (AST)、肌酸激酶 (CK)、乳酸脱氢酶 (LDH)、α -羟丁酸脱氢酶(HBDH)、肌酸激酶同功酶 (CK -MB) ,检测值进行比较。结果 :心肌酶术毕之间比较 ,AST、LDH和HBDH3项A组均高于B组和C组 ,(P<0 01) ;CK和CK—MB2项A组高于C组 ,(P<0 01) ;CK—MB1项B组均高于A组和C组 ,(P<0 01)。术后36小时之间比较 ,AST、CK、LDH和HBDH4项B组均高于A组和C组 ,(P<0 01) ;CK—MB1项A组高于C组 ,(P<0 01)。结论 :氧合血与晶体冷停跳液 (4 :1)混合灌注优于晶体冷停跳液灌注和不停跳转流方式灌注 。Objective:To compare the effect of three kinds of perfusion of extracorporeal circulation on myocardial enzyme.Methods:41cases with ASA in gradeⅠ～Ⅱwere divided into three groups,namely group A,group B and group C.17cases in group A were perfused with crystal cold-stop jumpy liquid;12cases in group B with non-stop-jumpy turned liquid;12cases in group C with mixed fluid of oxygenation blood and crystal cold-stop jumpy liquil.The induction drug of anesthesia was diazepam,haloperidol,fentanyl,propofol and vecuronium bromide,the maintenance drug was fentanyl and vecuronium bromide.The glutamic-oxalacetic transaminase(GOTor AST),creatine kinase(CK),lactic dehydrogenase(LDH),α-hydroxybutyric dehydrogenase(HBDH)and creatine kinase-musclebrain hybrid(CK-MB)in each group were deˉtected in36hours before and after operation as well as intraoperation respectively,and the results were compared.Results:All the values of AST,LDH and HBDH in group A were higher than those in the group B and group C(P<0.01);The values of CKand CK-MB in group A were higher than those in the group C(P<0.01);The value of CK-MB in group A was higher than that in the group A and group C(P<0.01).After opˉeration36hours,all the values of AST,CK,LDH and HBDH in the group B were higher than those in the group A and group C(P<0.01);The value of CK-MB in group A was higher than that in the group C(P<0.01).Conclusion:The mixed perfusion of oxygenation blood and crystal cold-stop jumpy liquil(4:1)is superior to the perfusion of crystal cold-stop jumpy liquil and non-stop-jumpy turned liquil,and the perfusion of crystal cold-stop jumpy liquil is superior to the perfusion of non-stop-jumpy turned liquil.

关 键 词：体外循环 灌注方式 心肌酶 晶体冷停跳液 不停跳转流 

分 类 号：R654.1[医药卫生—外科学]