摘要
目的观察分析老年冠心病患者胃癌手术麻醉诱导前应用参附注射液预处理的心脏保护作用效果。方法将2014年3月至2016年7月行胃癌切除术老年患者54例,随机平分为对照组和干预组。两组患者均行全麻,干预组患者在术前半小时静脉滴注1 ml/kg参附注射液(加入250 ml的5%葡萄糖注射液),对照组患者则在同一时间点静脉滴注250 ml 5%葡萄糖注射液。比较两组患者治疗前、治疗后24 h的心功能指标及治疗前、治疗后不同时间段的血清心肌肌钙蛋白(c Tn I)、肌酸激酶同工酶(CK-MB)水平,并统计患者手术后3 d内的心脏不良事件发生情况。结果两组患者治疗后的心功能指标、血清c Tn I和CK-MB水平均较治疗前明显升高,差异有统计学意义(P<0.05),且干预组患者治疗后6 h、12 h、24 h的血清c Tn I水平、CK-MB水平及治疗后24 h左心射血分数、心排量、心脏指数均较同时段对照组优势显著(P<0.05);同时干预组发生无症状心肌缺血2例(7.4%)明显少于对照组发生无症状心肌缺血8例(29.6%)(P<0.05)。结论参附注射液对降低老年冠心病胃癌手术患者的血清c Tn I、CK-MB水平,提高患者心功能具有显著的临床疗效,降低患者术后不良心脏事件发生率,对患者心脏起到了较好的保护作用。
Objective To observe the cardiac protection effect of Shenfu Injection in patients with coronary heart disease before gastric cancer operation.Methods 54 patients with coronary heart disease before gastric cancer operation selected in our hospital from March 2014 to July 2016 were randomly divided into two groups,two groups patients were treated with general anesthesia,the intervention group patients were given1 ml/kg(with 250 ml of 5% glucose injection) Shenfu injection intravenously about half an hour before surgery,control group patients at the same time were given 250 ml 5% glucose injection intravenous,compared the differences of two groups patients before and after treatment 24 hours on heart function and serum c Tn I levels,CK-MB levels at different treatment time,also the difference of patients Cardiac adverse events occurred rate within 3 days after surgery.Results The serum c Tn I,CK-MB levels and cardiac function indexes of the two groups patients were significantly different from those before treatment,and the serum c Tn I,CK-MB levels at 6 h,12 h and 24 h after treatment and left ventricular ejection fraction(LVEF),cardiac output and cardiac index at 24 h after treatment in the intervention group were significantly higher than those in the control group(P < 0.05).Also 2 cases(7.4%) with asymptomatic myocardial ischemia occurred in the intervention group,which were less than 8 cases(29.6%) with asymptomatic myocardial ischemia occurred in the control group(P < 0.05).Conclusion Shenfu injection can decrease the level of serum c Tn I and CK-MB in elderly patients with coronary heart disease and improve the cardiac function,it can reduce the incidence of adverse cardiac events and has a good cardiac protective effect.
出处
《临床和实验医学杂志》
2018年第2期159-162,共4页
Journal of Clinical and Experimental Medicine
基金
湖北省教育厅科研项目(编号:B2016116)
关键词
老年
冠心病
参附注射液
心脏保护
Elderly
Coronary heart disease
Shenfu injection
Heart protection
