摘要
目的对自体血浆替换联合琥珀酰明胶在体外循环中的应用效果进行探析。方法选取2017年6月-2018年6月来该院进行心脏瓣膜置换手术的病患共100例作为实验研究对象,根据随机数字法分为对照组和观察组各50例,对照组病患体外循环预充液运用琥珀酰明胶,观察组病患体外循环运用自体血浆替换琥珀酰明胶预充液。对比两组病患体外循环预充前,中,后3个阶段和手术后1 h,3 h后的血细胞比容(血细胞在全血中所占的容积百分比,即Hct),和血浆乳酸水平(Lac)。对比两组病患心脏瓣膜置换术前,术后24 h以及术中开放主动脉后1h的肌酸激酶同工酶,血清肌钙蛋白以及肌酸激酶的指标水平。结果观察组患者手术后3 h的血细胞比容(35.53±3.67)%显著高于对照组(31.23±2.96)%,差异有统计学意义(t=0.425,P<0.05);血浆乳酸水平(3.12±0.75)mg/dL显著低于对照组(5.22±1.34)mg/dL差异有统计学意义(t=0.482,P<0.05)。观察组患者术后24 h(63.39±22.08)U/L的肌酸激酶同工酶,血清肌钙蛋白(0.503±0.221)μg/L以及肌酸激酶(629.70±182.31)U/L的指标水平显著低于对照组(93.32±32.08)U/L;(0.881±0.221)μg/L;(869.95±192.52)U/L,差异有统计学意义(t=0.824,P<0.05)。结论在心脏瓣膜手术前进行体外循环预充中用自体血浆替代联合琥珀酰明胶可有效保护病患的心肌功能,增加机体有效循环血容量,具有一定价值,值得在临床推广应用。
Objective To explore the effect of autologous plasma replacement combined with succinyl gelatin in cardiopulmonary bypass. Methods A total of 100 patients who underwent cardiac valve replacement from June 2017 to June 2018 in our hospital were selected as experimental subjects. According to the random number method, they were divided into the control group and the observation group, 50 cases in each group. The patients in the control group were treated with succinyl gelatin for cardiopulmonary bypass(CPB) and the patients in the observation group were treated with autologous plasma for amber during CPB. Acyl gelatin pre-filling solution. The hematocrit(Hct) and plasma lactate level(Lac) of the two groups were compared before, during, after cardiopulmonary bypass(CPB) and 1 h and 3 h after operation. The levels of creatine kinase isoenzymes, serum troponin and creatine kinase before and 24 hours after heart valve replacement and 1 hour after aortic opening were compared between the two groups. Results The hematocrit(35.53±3.67)% of the observation group was significantly higher than that of the control group(33.23±96.6)%, and the difference was statistically significant(t=0.425, P<0.05). The plasma lactate level(3.12±0.75)mg/dL was significantly lower than that of the control group(5.22±1.34)mg/dL, and the difference was statistically significant(t=0.482, P<0.05).In the observation group, the levels of creatine kinase isoenzyme, serum troponin(0.503±0.221)μg/L and creatine kinase(629.70±182.31)U/L at 24 h(63.39±22.08)U/L were significantly lower than those in the control group(93.32±32.08)U/L.(0.881±0.221)μg/L;(869.95±192.52)U/L, the difference was statistically significant(t=0.824, P<0.05). Conclusion Autologous plasma instead of succinyl gelatin in cardiopulmonary bypass(CPB) pretreatment before cardiac valve surgery can effectively protect patients’ myocardial function and increase the effective circulatory blood volume,which has a certain value and is worthy of clinical application.
作者
陈治富
CHEN Zhi-fu(Department of Anesthesiology,People's Hospital of Baoji,Baoji,Shanxi Province,721000 China)
出处
《系统医学》
2019年第9期4-6,共3页
Systems Medicine
关键词
自体血浆
琥珀酰明胶
体外循环
预充液
Autologous plasma
Succinyl gelatin
Cardiopulmonary bypass
Priming solution
