摘要
目的回顾性分析比较在心脏瓣膜手术中HTK停搏液与del Nido停搏液的心肌保护效果。方法收集选取2019年1月至2021年12月在阜外华中心血管病医院行体外循环(CPB)下心脏直视手术的153例成人心脏瓣膜患者纳入研究。依据使用心脏停搏液不同而分为两组,HTK停搏液组(71例)和del Nido停搏液(冷D组,82例)。采集血液中心肌损伤标志物数据及愈后情况作临床比较。结果两组在CPB时间、升主动脉阻断时间、术后机械通气时间、ICU停留时间、术后出院时间、电击复跳率、术后并发症的发生率及病死率等方面均无统计学差异(P>0.05);两组在术后24h血液指标中超敏肌钙蛋白(P=0.08)、肌酸激酶(P=0.68)、心肌肌酸激酶同工酶(P=0.06)、N端-BNP(P=0.05)无统计学差异(P>0.05)。在停搏液灌注用量方面冷D组较少(P=0.001),HTK组所需灌注次数更少(P<0.001)。出院后1月门诊复查,两组患者左心室射血分数值、左心室收缩末内径,左心室舒张末内径无显著性差异(P>0.05)。结论在心脏瓣膜手术中,应用HTK停搏液及delNido停搏液都具有良好的心肌保护效果。
Objective To retrospectively analysis and compare the myocardial protective effect of HTK cardioplegia and del Nido cardioplegia in heart valve surgery.Methods A total of 153 adult patients with heart valve disease who underwent open-heart surgery under cardiopulmonary bypass(CPB)in Fuwai Central China Cardiovascular Hospital from January 2019 to December 2021 were enrolled in this study.According to the use of cardiac arrest fluid,the patients were divided into two groups:71 patients were offered HTK cardioplegia(the HTK group)and 82 patients received del Nido cardioplegia(the cold D gruop).Blood myocardial injury markers and prognosis were collected for clinical comparison.Results There were no significant differences in CPB time,ascending aorta occlusion time,postoperative mechanical ventilation time,ICU stay time,ostoperative discharge time,shock repulse rate,incidence of postoperative complications and mortality between the two groups(P>0.05).There were no significant differences in the levels of cTnI(P=0.08),Mb(P=0.68),CK-MB(P=0.06)and BNP(P=0.05)between the two groups at 24 hours after operation(P>0.05).The amount of cardioplegia perfusion was less in the cold D group(P=0.001),however,the number of perfusion was less in the HTK group(P<0.001).At 1 month after discharge from the hospital,there were no significant differences in left ventricular ejection fraction,left ventricular end-systolic diameter and left ventricular end-diastolic diameter between the two groups(P>0.05).Conclusion Both HTK cardioplegia and del Nido cardioplegia have good myocardial protective effects in heart valve surgery.
作者
陈乾坤
程兆云
李正玉
王圣
胡俊龙
张华坤
刘前进
CHEN Qian-kun;CHENG Zhao-yun;LI Zheng-yu;WANG Sheng;HU Jun-long;ZHANG Hua-kun;LIU Qian-jin(Department of Cardiovascular Surgery,Henan University People’s Hospital,Henan Provincial People’s Hospital,Zhengzhou,Henan 450003,China;Heart Center,Henan Provincial People’s Hospital,Fuwai Central China Cardiovascular Hospital,Zhengzhou,Henan 451464,China;Cardiopulmonary Bypass Department,Henan Provincial People’s Hospital,Fuwai Central China Cardiovascular Hospital,Zhengzhou,Henan 451464,China)
出处
《中国心血管病研究》
CAS
2023年第1期30-35,共6页
Chinese Journal of Cardiovascular Research
基金
河南省医学科技攻关计划项目(SBGJ202101005),河南省医学科技攻关计划项目(LHGJ20220111),河南省医学教育研究项目(Wjlx2020167)。
关键词
HTK液
delNido液
心肌保护
心脏瓣膜手术
心肺转流
HTK cardioplegia
del Nido cardioplegia
Myocardial protection
Heart valve surgery
Cardiopulmonary bypass
