摘要
目的 为了较好地进行心肌保护 ,研究主动脉开放前热血加甘露醇灌注在危重心脏瓣膜病患者体外循环术中的应用。 方法 选取我院 1998年 6月～ 1999年 6月间 80例心脏瓣膜病患者 ,随机分为实验组和对照组 ,每组各 40例 ,常规行二尖瓣和 /或主动脉瓣置换术。两组均采用中度低温含血心肌保护 ,实验组于主动脉开放前给予热血加甘露醇灌注。比较两组患者体外循环术后心功能恢复情况。 结果 在自动复跳率、主动脉开放后体外循环时间、2 4小时内心排血指数恢复速度、肌酸激酶下降幅度等指标实验组明显优于对照组 (P<0 .0 5 ) ,在术后呼吸机支持时间、ICU滞留时间、正性肌力药物使用率、手术死亡率等方面两组无明显差异 (P>0 .0 5 )。 结论 主动脉开放前热血加甘露醇灌注能明显减轻再灌注损伤 ,加快术后早期心功能恢复。
Objective\ To assess the efficacy of warm blood and mannitol reperfusion in extracorporeal circulation for patients with severe valvular heart diseases.\ Methods\ Eighty patients with valvular heart diseases between 1998 6 and 1999 6 were selected and randomly divided into test group and control group. Mitral valve replacement, aortic valve replacement or double valve replacement was performed in those patients. All the patients were given continuous mild hypothermia(28±3℃) blood myocardial protection, while only the patients in test group were exposed to warm blood and mannitol reperfusion before unclamping the aortic artery. The auto beating ratio, assistant time after unclamping aortic artery, trend of cardiac index and creatine kinase change after operation, supporting time by respirator, time in ICU and mortality of two groups were compared.\ Results\ The patients in test group performed better in auto beating ratio, assistant time after unclamping aortic artery and velocity of cardiac index resumed and creatine kinase descending after operation than the patients in control group ( P<0.05) . There was no significant differences in the supporting time by respirator, time in ICU and mortality between two groups ( P> 0.05) .\ Conclusion\ Warm blood and mannitol reperfusion is benefit to the myocardial protection in patients with severe valvular heart diseases.
出处
《中国胸心血管外科临床杂志》
CAS
2001年第1期18-20,共3页
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
关键词
热血
甘露醇
体外循环
危重心脏瓣膜疾病
Warm blood
\ Mannitol
\ Extracorporeal circulation
\ Severe valvular heart diseases
