摘要
目的探讨Del Nido心肌保护液在成人心脏手术中心肌保护效果,分析其在成人心脏直视术中相关优势。方法回顾性分析2016年6月至2017年1月我院成人心脏瓣膜术中应用Del Nido心肌保护液96例患者的临床资料,其中男44例、女52例,平均年龄(51.36±13.31)岁,作为Del Nido心肌保护液组(DNC组)。选取同期应用传统心肌保护液96例患者作为传统心肌保护液组(CTC组),其中男53例、女43例,平均年龄(52.91±10.95)岁。记录主动脉阻断时间、体外循环时间、心肌保护液灌注次数及总量、自动复跳率、围术期输血量及术后24 h内正性肌力药使用情况等。结果 DNC组和CTC组患者年龄、体质量、射血分数、红细胞压积、体外循环时间、主动脉阻断时间差异无统计学意义(P>0.05)。两组自动复跳率、术后24 h正性肌力药物评分、心肌酶学、肌钙蛋白-I及住ICU时间差异无统计学意义(P>0.05)。与CTC组相比,DNC组术中心肌保护液灌注总量、灌注次数、围术期输血量均较少,差异具有统计学意义(P<0.05)。两组术后均无新发心房颤动及院内死亡。结论 Del Nido心肌保护液在成人心脏瓣膜手术中有良好的心肌保护作用,同时可减少静态预充量,降低血液稀释及围术期输血量。
Objective To investigate the myocardial protective effects of Del Nido cardioplegia and analyze its advantages in adult cardiac surgery. Methods We retrospectively analyzed the clinical data of 96 adult patients undergoing cardiac valve surgery who received Del Nido cardioplegia（a DNC group） from June 2016 to January 2017 in our hospital. There were 44 males and 52 females with a mean age of 51.36±13.31 years. Meanwhile 96 patients who received conventional cardioplegia were recruited as a control group（a CTC group） and there were 53 males and 43 females with a mean age of 52.91±10.95 years. Cross-clamping time, cardiopulmonary bypass（CPB） time, total volume of and transfusion frequency of cardioplegia, the rate of spontaneous defibrillation, red blood cell transfusion and vasoactiveinotropic score at postoperative 24 hours（VIS 24） were recorded. Results No significant difference was found in age,body weight, ejection fraction, hematokrit, CPB time and cross-clamping time between the DNC group and CTC group.There was no significant difference in the rate of spontaneous defibrillation, VIS 24, cardiac enzymes and cardiactroponin I and length of ICU stay between the two groups. The total volume and transfusion frequency of cardioplegia,perioperative blood transfusion were lower in the DNC group. There was no new atrial fibrillation or in-hospital death in the two groups. Conclusion Del Nido is a good myocardial protection solution in adult cardiac valve surgery, and requires less static preload volume and reduces hemodilution and perioperative blood transfusion.
作者
吕晓钗
叶建熙
刘燕
LV Xiaochai;YE Jianxi;LIU Yan(Department of Cardiac Surgery,Union Hospital,Fujian Medical University,Fuzhou,350001,P.R.China)
出处
《中国胸心血管外科临床杂志》
CAS
CSCD
2018年第9期781-785,共5页
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
