摘要
目的探讨三氧自体血回输对冠状动脉病变患者非心脏手术后心肌损伤的影响。方法选取择期行胃癌、肠癌、食管癌根治术患者90例,随机分为三氧治疗组(n=45)和对照组(n=45)。三氧治疗组于手术当天及术后第1、2天行三氧自体血回输治疗,对照组仅行自体血回输。于麻醉前(T_(0))、术后6 h(T_(1))、术后12 h(T_(2))、术后24 h(T_(3))、术后48 h(T_(4))抽取静脉血,检测血浆中心肌肌钙蛋白I(cTnI)、心肌肌钙蛋白T(cTnT)含量。采用经胸超声测量三尖瓣前叶瓣环的移位(TAPSE)及左室射血分数(LVEF)。记录术后24 h血管活性药物分数(VIS)、C反应蛋白(CRP)、白细胞介素-6(IL-6)和术中时间加权平均动脉压(TWA-MAP)。结果2组患者术后的cTnI、cTnT均有不同程度升高,与对照组比较,三氧治疗组T_(2)、T_(3)、T_(4)时cTnI及cTnT表达减少,差异有统计学意义(P<0.05)。与对照组相比,三氧治疗组LVEF和TAPSE在T_(1)、T_(2)、T_(3)时均增加,且术后24 h的VIS分数降低,差异有统计学意义(P<0.05)。与对照组相比,三氧治疗组患者术后24 h的CRP及IL-6降低,差异有统计学意义(P<0.05)。结论三氧自体血回输可改善冠状动脉病变患者非心脏手术后的心肌损伤。
Objective To explore the effect of ozonated autohemotransfusion on myocardial injury of patients with coronary artery abnormality after non-cardiac surgery.Methods Totally 90 patients with selective radical resections of gastric,intestinal and esophageal cancers were randomly divided into ozonated autohemotransfusion group(n=45)and control group(n=45).The ozonated autohemotransfusion group was treated with ozonated autohemotransfusion therapy at the time points of the day of operation and the first day and second days after operation,while the control group was only treated with autohemotransfusion.Venous blood was collected for detection of cardiac troponin I(cTnI)and cardiac troponin T(cTnT)in plasma at the time points of before anesthesia(T_(0))and 6,12,24 and 48 hours after surgery(T_(1),T_(2),T_(3),T_(4)).Tricuspid annular plane systolic excursion(TAPSE)and left ventricular ejection fraction(LVEF)were measured by transthoracic ultrasound.Vasoactive inotrope score(VIS),C reactive protein(CRP),interleukin-6(IL-6)and intraoperative time-weighted average mean arterial pressure(TWA-MAP)were recorded at 24 hours after operation.Results The levels of cTnI and cTnT in both groups raised in varying degrees after surgery,and the cTnI and cTnT levels at T_(2),T_(3) and T_(4) in the ozonated autohemotransfusion group were significantly lower than those in the control group(P<0.05).Compared with the control group,the LVEF and TAPSE at T_(1),T_(2) and T_(3) increased significantly in the ozonated autohemotransfusion group,while the VIS decreased significantly at 24 hours after operation(P<0.05).Compared with the control group,the CRP and IL-6 significantly decreased at 24 hours after operation in the ozonated autohemotransfusion group(P<0.05).Conclusion Ozonated autohemotransfusion can improve the myocardial injury of patients with coronary artery abnormality after non-cardiac surgery.
作者
诸亮
许灵珊
吴周全
邹志清
ZHU Liang;XU Lingshan;WU Zhouquan;ZOU Zhiqing(Department of Anesthesiology,Changzhou Second People′s Hospital Affiliated to Nanjing Medical University,Changzhou,Jiangsu,213000;Nanjing Medical University,Nanjing,Jiangsu,211166)
出处
《实用临床医药杂志》
CAS
2021年第18期102-106,共5页
Journal of Clinical Medicine in Practice
基金
江苏省卫生健康委面上项目(H2018047)
江苏省青年卫生人才项目(QNRC2016273)。
关键词
三氧自体血回输
心肌损伤
心肌肌钙蛋白
冠心病
时间加权平均动脉压
ozonated autohemotransfusion
myocardial injury
cardiac troponin
coronary heart disease
time-weighted average mean arterial pressure
