摘要
目的:观察吸入七氟烷麻醉对非发绀型先天性心脏病(先心病)患儿心脏手术围术期血浆心肌坏死标记物肌钙蛋白Ⅰ(TnI)及肌酸激酶同工酶(CKMB)的影响。方法:择期行心脏手术的非发绀型先心病患儿60例,随机分为七氟烷组(S组)及氯胺酮组(K组),分别在术中实施七氟烷-芬太尼或氯胺酮-芬太尼麻醉,观察术中的血流动力学及围术期TnI、CKMB、血糖(Glu)及乳酸(Lac)水平变化。结果:S组与K组比较,S组平均动脉压(MAP)在诱导后、切皮及术毕均比K组高(P<0.05),S组HR在术毕比K组低(P<0.05),S组在术后4 h及24 h TnI水平显著低于K组(P<0.05),CKMB在术后24 h显著低于K组水平(P<0.05),2组Glu及Lac浓度在各时点差异无统计学意义(P>0.05)。结论:吸入七氟烷麻醉在非发绀型先心病患儿心脏手术围术期,可以降低血浆TnI及CKMB水平,对患儿心肌可能起到保护作用。
Objective：To observe the effect of sevoflurane inhalation anesthesia on myocardial injury biomarker Troponin I（TnI） and MB isoenzyme of creatine kinase（CKMB） in non-cyanosis congenital heart disease infants undergoing cardiac surgery.Methods：Sixty non-cyanosis congenital heart disease infants undergoing selective cardiac surgery were recruited for present study.Patients were randomly assigned to sevoflurane group（Group S） and ketamine group（Group K） and received sevoflurane inhalation or ketamine injection for anesthetic induction and maintenance respectively.Intraoperative hemodynamics were recorded and perioperative serum level of TnI,CKMB,blood glucose and lactate were measured.Results： Mean artery pressure increased significantly in Group S compared with Group K at post-induction,skin incision and at the end of the surgery（P0.05）,Heart rate in Group S was significantly lower than that of in Group K（P0.05）.The serum TnI level in group S was significantly lower than that of Group K at postoperative 4h and 24h respectively（P0.05）.The values of CKMB were significantly lower in Group S（P0.05）.The blood glucose and lactate showed no difference between two groups.Conclusion： The present study demonstrates that anesthesia with sevoflurane for non-cyanosis congenital heart disease infants may decrease serum level of myocardial injury biomarker（TnI and CKMB）.This results implies the myocardial protection effect of sevoflurane for infant undergoing cardiac surgery.
出处
《心肺血管病杂志》
CAS
2012年第2期124-126,共3页
Journal of Cardiovascular and Pulmonary Diseases
关键词
七氟烷
非发绀型先心病
患儿
心肌保护
Sevoflurane
Non-cyanosis congenital heart disease
Infant
Myocardial protection
