摘要
目的研究动脉血乳酸、降钙素原及NT-proBNP运用于体外循环心脏手术患者中的评估价值。方法选取我院2017年1月~2019年4月纳入的65例体外循环心脏手术患者作为研究对象,分别于术后不同时间段进行动脉血乳酸、降钙素原及NT-proBNP水平检测,观察检测结果并分析其在术后评估中的价值。结果所有研究对象经过手术后,其中有62例存活,另3例死亡。存活者中发生并发症者有20例,包含消化系统意外事件有5例,其中不明原因腹痛3例,急性肝功能损伤2例;循环系统意外事件4例,其中低心排综合征1例,顽固性高血压2例,心律失常1例;泌尿系统意外事件2例;术后感染7例;神经系统意外事件2例。存活组术后0h、术后8h、术后1d、术后2d的动脉血乳酸均低于死亡组,而术后8h、术后1d、术后2d的降钙素原及NT-proBNP水平低于死亡组,差异有统计学意义(P<0.05)。术后2d并发症组的动脉血乳酸、降钙素原及NT-proBNP水平均高于未发生并发症组,差异有统计学意义(P<0.05)。结论动脉血乳酸、降钙素原及NT-proBNP运用于体外循环心脏手术中具有重要的价值,可准确评估术后病情变化,对手术风险进行预测,值得临床推广使用。
Objective To study the evaluation value of arterial blood lactate,procalcitonin and NT-proBNP in patients undergoing cardiopulmonary bypass.Methods 65 patients undergoing cardiopulmonary bypass enrolled at our hospital from January 2017 to April 2019 were selected as the study objects.The levels of arterial blood lactate,procalcitonin and NT-proBNP were detected at different time periods after surgery.The detection results were observed and their value in postoperative evaluation was analyzed.Results After surgery,62 of the study objects survived and 3 died.Among the survivors,there were 20 cases of complications,including 5 cases of digestive system accidents,wherein there were 3 cases of unexplained abdominal pain,and 2 cases of acute liver function injury;there were 4 cases of circulatory system accidents,wherein there was 1 case of low cardiac output syndrome,2 cases of intractable hypertension,and 1 case of arrhythmia;there were 2 cases of urinary system accidents;there were 7 cases of postoperative infection;there were 2 cases of nervous system accidents.At 0h,8h,1d and 2d after surgery,the arterial blood lactate in the survival group was lower than that in the death group,while at 8h,1d and 2d after surgery,the levels of procalcitonin and NT-proBNP were lower than those in the death group,with statistically significant difference(P<0.05).At 2d after surgery,the levels of arterial blood lactate,procalcitonin and NT-proBNP in the complication group were all higher than those in the complication-free group,with statistically significant difference(P<0.05).Conclusion The application of arterial blood lactate,procalcitonin and NT-proBNP in cardiopulmonary bypass has important value,which can accurately evaluate the changes in postoperative conditions and predict the risks of surgery,which is worthy of clinical promotion and use.
作者
王琼
WANG Qiong(Department of Cardiothoracic Surgery,Second People's Hospital of Zhaoqing,Guangdong,Zhaoqing 526060,China)
出处
《中国医药科学》
2020年第11期116-119,共4页
China Medicine And Pharmacy
