摘要
目的研究在体外循环（CPB）下行心脏瓣膜置换术中联合应用复合辅酶及门冬氨酸钾镁对缺血心肌术后复跳的影响。方法将82例心脏瓣膜病患者随机分为两组，治疗组和对照组，各41例，两组麻醉方法相同、术前治疗相同。治疗组静脉缓慢注入复合辅酶200U及门冬氨酸钾镁；对照组只给门冬氨酸钾镁及常规治疗，然后观察两组术后心脏自动复跳情况和复跳后心律失常和低心排量发生情况。结果治疗组的自动复跳率明显高于对照组（97．56％与80．49％，x^2=6．12，P=0．01）；复跳后24h内严重室性心律失常的发生率两组比较差异有统计学意义（19．51％与41．46％，x^2=4．67，P=0．03）；低心排量综合征发生率两组比较差异有统计学意义（14．63％与36．58％，x^2=5．18，P=0．02）；以联合疗法为变量评价对心脏自动复跳的影响进行两项式Logistic回归分析，结果其优势比OR值为9．69，95％CI：1．15～81．55，P=0．03；经多变量Logistic回归分析显示影响心脏自动复跳的其他因素还有：主动脉阻断时间（OR=9．28，95％CI：1．21—78．18，P：0．01）、心脏功能（OR=4．95，95％CI：1．27—17．88，P=0．02）、手术时间（OR=3．99，95％CI：1．18—11．62，P=0．04）、年龄（OR=2．77，95％CI：1．11—9．74，P=0．04）。结论在心脏瓣膜置换术中联合应用复合辅酶及门冬氨酸钾镁有利于术后的心脏复跳并减少复跳后严重心律失常的发生，并减少心脏低心排量的发生。
Objective To evaluate the curative effect of coenzyme complex and potassium magnesium aspartate on the restoration of rhythm and anti-arrhythmia in postoperative valve replacement patients for rheumatic heart disease. Methods Eight two patients with rheumatic heart disease were randomized into 2 groups,with no statistical significance in the patients＇ parameters. Treatment group A （ n = 41 ） received i. v. coenzyme complex and potassium magnesium aspartate 30 ml during operation. Group B（ n = 41 ）were only given potassium magnesium aspartate 30 ml. Other conventional therapies were the same for the two groups. At the same time, rate of spontaneous restoration of rhythm and severe arrhythmia incidences and low cardiac output syndrome were also recorded. Results The rate of spontaneous restoration of rhythm in the treatment group were higher than that in the control group （ 97. 56% vs 80. 49%, X2 = 6. 12, P = 0. 01 ）. There were significant differences in the severe ventricular tachycardia, ventricle fibrillation and auricular flutter events between the 2 groups（ 19. 51% vs 41.46%, 2 =4. 67 .P = 0. 03）. The rate of low cardiac outout in the treatment grouo werelower than that in the control group（ 14. 63% vs 36. 58%, X2 = 5.18,P = 0. 02）. To evaluate the effect of combination therapy on the spontaneous restoration of rhythm,Logistic regression analysis showed that OR（ odds ratio）value was 9. 69 and 95% CI（ confidence interval）was 1.15 -81.55 （P = 0. 03 ）. Other variables affecting the spontaneous restoration of rhythm included the time of aortic obstruction（ OR =9. 28,95% CI 1.21 -78.18, P = 0. 02 ） and cardiac function before operation （ OR = 4. 95,95% C1 1.27 - 17. 88, P = 0.02 ） , operating time （ OR =3.99,95% CI 1.18 - 11.62 ,P =0.04） ,age（ OR =2. 77,95% C1 1.11 -9. 74 ,P =0. 04）. Conclusion Combined administration of coenzyme complex and potassium and magnesium aspartate in the operation of valve replacement in patients With rheumatic heart disease is able to p
出处
《中国综合临床》
2012年第5期538-541,共4页
Clinical Medicine of China
关键词
心脏瓣膜置换
门冬氨酸钾镁
复合辅酶
心脏复跳
Heart valve replacement
Potassium magnesium aspartate
C0enzyme complex
Restoration of heart rhythm
