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七氟烷全程吸入在婴幼儿先天性心脏病矫治术中的心肌保护作用 被引量:1

Study of Myocardial Protection in Surgical Inhalation of Sevoflurane in Infants with Congenital Heart Diseases
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摘要 目的探讨七氟烷全程吸入在婴幼儿体外循环(cardiopulmonary bypass,CPB)下先天性心脏病(congenital heart disease,CHD)矫治术中心肌保护的效果。方法选取择期CPB下CHD矫治术患儿38例,年龄0~3岁,ASAⅡ或Ⅲ级,随机地被均分成七氟烷组(S组)和丙泊酚组(P组)。患儿麻醉诱导行气管插管术后,S组持续吸入七氟烷至术毕;P组静脉持续泵注丙泊酚2 mg/(kg·h)至手术结束。记录患儿CPB时间、主动脉阻断(ACC)时间以及麻醉诱导前、麻醉诱导后、切皮后、劈胸骨后及术毕的MAP、HR,分别于术前(T0)、主动脉开放后6 h (T1)、24 h (T2)、48 h (T3)、72 h (T4)抽静脉血测定心肌肌钙蛋白I (c TnI)和肌酸激酶同工酶(CK-MB)的水平。结果两组患儿CPB时间、ACC时间及T0~T4各时间点MAP、HR比较差异无统计学意义(P>0.05);两组患儿术前c TnI和CK-MB均在正常范围内,在T1、T2、T3、T4时间点明显升高,差异有统计学意义(P<0.05),两组间各时点的比较,差异无统计学意义(P>0.05)。结论七氟烷全程吸入在婴幼儿先天性心脏病矫治术中具有与丙泊酚相近的心肌保护作用,值得临床推广。 Objective To investigate the effect of sevoflurane total inhalation on myocardial protection in infants underwent cardiopulmonary bypass(CPB) for congenital heart disease(CHD). Me thods 38 patients with elective CHD correction surgery under CPB, aged 0-3 years old, ASA II or III, were randomly divided into the sevoflurane group(Group S) and the propofol group(Group P). After anesthesia was induced and the tracheal intubation, Group S continued inhaling sevoflurane to the end of surgery;Group P were pumped with propofol 2 mg/(kg·h) to the end of surgery. The CPB time, ACC time, and changes in MAP and HR before induction of anesthesia, after induction of anesthesia, after skin incision, after retrosternal sternum, and postoperative were recorded. The c TnI and CK-MB levels were collected before surgery(T0),and at 6 h(T1),24 h(T2), 48 h(T3), 72 h(T4) after aorta opening. Results There were no significant differences in the general data between the two groups(P > 0.05). There were no significant differences in CPB and ACC time and no significant differences in MAP and HR at T0-T4 in the two groups(P > 0.05);Preoperative c TnI and CK-MB were within the normal range in both groups, and significantly higher at T1, T2, T3, and T4 time points(P <0.05) and no statistically difference between the two groups at each time point(P > 0.05). Conclus ion Total inhalation of sevoflurane has similar myocardial protection effect as propofol on infants with congenital heart disease,which is worthy of clinical promotion.
作者 方楚龙 李亚雄 王小燕 王钊 汪毅 周财勤 闫明亮 李曙熙 刘碧 FANG Chu-long;LI Ya-xiong;WANG Xiao-yan;WANG Zhao;WANG Yi;ZHOU Cai-qin;YAN Ming-liang;LI Shu-xi;LIU Bi(Dept.of Cardiovascular Surgery,The Affiliated Yan’an Hospital of Kunming Medical University,Kunming Yunnan 650051,China)
出处 《昆明医科大学学报》 CAS 2020年第4期137-141,共5页 Journal of Kunming Medical University
基金 昆明市卫计委基金资助项目(2016SWRC009)。
关键词 七氟烷 全程吸入 婴幼儿先天性心脏病 丙泊酚 心肌保护 Sevoflurane Total inhalation Infantile congenital heart disease Propofol Myocardial protection
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