摘要
目的比较HTK液和含血停搏液在风湿性心脏病患者瓣膜置换术中的心肌保护效果。方法将42例风湿性心脏病联合瓣膜病的患者随机分为对照组(应用1∶4冷含血停搏液)和实验组(应用HTK液),测定2组术前及主动脉开放后6 h、12 h、24 h血中磷酸激酶(CK)、磷酸激酶同工酶(CK-MB)和肌钙蛋白Ⅰ(cTnⅠ)的浓度,并比较2组患者主动脉阻断时间、主动脉开放到心脏复搏时间、辅助循环时间、心脏自动复搏率、多巴胺应用剂量、呼吸机支持时间等临床指标。结果对照组CK、CK-MB和cTnI浓度在主动脉开放后6 h、12 h、24 h均明显高于实验组;主动脉阻断时间、主动脉开放到心脏复搏时间、辅助循环时间、多巴胺剂量、呼吸机支持时间均高于实验组,心脏自动复搏率低于实验组。结论 HTK心脏停搏液对风湿性心脏病患者瓣膜置换术中心肌的保护作用优于1∶4含血停搏液。
Objective It is to compare the myocardial protecting effects between HTK solution and blood cardioplegic solution during valve replacement surgery in patients with rheumatic heart disease.Methods 42 patients with rheumatic heart disease complicating with valvular disease were randomly divided into control group(given 1∶ 4 cold blood cardioplegic solution) and experimental(given HTK solution).Plasma levels of Creafine Kinase(CK),creatine kinase MB(CK-MB) and cardiac troponin Ⅰ(cTnⅠ) were measured before operation,and in 6 hours,12 hours and 24 hours after aorta declamped.Aortic clamping time,the ratio of spontaneous cardiac rhythm recovery,inotropic drugs application,mechanical ventilation support time and the incidence of arrhythmia of the patients in both groups were compared.Results The levels of CK,CK-MB and cTnI in experimental group were lower than that in control group at 6 hours,12 hours and 24 hours after aorta declamped.The clinical parameters including aortic clamping time,inotropic support,duration of mechanical ventilation and length was lower than that in control group(P<0.05);the auto-beating rate was higher than that in control group(P<0.05).Conclusion HTK solution is superior to classical blood cardioplegia in myocardial protection during valve replacement.
出处
《现代中西医结合杂志》
CAS
2012年第29期3200-3201,共2页
Modern Journal of Integrated Traditional Chinese and Western Medicine
关键词
HTK液
含血停搏液
心肌保护
风湿性心脏瓣膜病
HTK solution
blood cardioplegic solution
myocardial protection
rheumatic valvular disease
