【摘要】 目的比较HTK液和含血停搏液在复杂心脏手术中的心肌保护效果。方法40例重症复杂心脏手术患者分为两组。HTK液组(16例)手术中采用HTK液保护心肌;对照组(24例)术中采用常规1:4含血停搏液保护心肌。测定术前、主动脉开放后8h、24h、48h血中肌钙蛋白I(cTn I)和磷酸激酶同工酶(CK-M B)浓度,并比较两组患者术后心脏自动复跳率、正性肌力药物使用率、机械通气支持时间、ICU监护时间等临床指标。结果HTK组和对照组平均体外循环转流时间和主动脉阻断时间无明显差异,术后心脏自动复跳率分别为87.5%、64.6%(P<0.05)。主动脉开放后8h、24h对照组cTn I和CK-M B均明显高于HTK组(P<0.05)。两组其余观察指标无明显差异。结论HTK心脏停搏液对复杂重症心脏手术患者的心肌保护作用略优于1:4含血停搏液。更多还原

【Abstract】 Objective:To compare the myocardial protective effect of HTK solution and blood cardioplegia during complicated cardiac operations.Methods:40 patients who underwent open heart operations were divided into two groups.HTK group(16 patients) in which HTK solution was used for myocardial protection during operations and control group(24 patients) in which multi-dose classical 1:4 blood cardioplegia was employed.Blood were sampled for measurement of cTn and CK-MB before operation and 8h,24h,48h after aortic declamping.The ratio of spontaneous cardiac rhythm recovery,inotropic drugs application were calculated and mechanical ventilation support time and ICU stay time were recorded.Results:There was no significant difference in average CPB time and aortic clamping time between two groups.But spontaneous normal rhythm recovery rate was significantly higher in HTK group(87.5%) than that in control group(64.6%,P<0.05)).The serum cTnI and CK-MB levels were remarkably higher 8h and 24h after aortic decalmping in control group than that in HTK group,and the difference between two groups were statistically significant(P<0.05).As for inotropic drugs application,mechanical ventilation support time and ICU stay time,there was no significant difference between two groups (P>0.05).Conclusion:HTK solution is slightly superior to classical blood cardioplegia in myocardial protection during open heart operations especially in complicated and seriously illed patients.更多还原