论文部分内容阅读
目的:探讨磷酸肌酸钠(CP)在婴幼儿心内直视术中的心肌保护作用及其临床应用价值。方法:选择40例房间隔缺损(ASD),或室间隔缺损(VSD)的先天性心脏病患儿,随机分为CP停搏液组和冷晶体高钾停搏液组。2组患儿均于体外循环(CPB)前、主动脉阻断10 min、转流结束后,术后2 h和术后12 h,抽取中心静脉血2 mL,测肌酸激酶-同工酶(CK-MB)和肌钙蛋白I(cTnI)的浓度;分别记录临床观察指标(体外循环时间、主动脉阻断时间、术后呼吸机辅助时间、手术结束后及术后12 h多巴胺用量)。结果:CP组临床观察指标优于对照组(P<0.05);2组CK-MB和cTnI浓度均于主动脉阻断后开始上升,于转流结束后达高峰,与CPB前比较差异有统计学意义(P<0.01)。2组间比较,实验组主动脉阻断后各时点升高的幅度低于对照组,差异有统计学意义(P<0.05)。结论:婴幼儿心内直视术中,应用含CP的停搏液对婴幼儿心肌具有良好的保护作用。
Objective: To investigate the myocardial protection and clinical value of sodium creatine phosphate (CP) in infants undergoing open heart surgery. Methods: Forty children with congenital heart disease with atrial septal defect (ASD) or ventricular septal defect (VSD) were randomly divided into CP cardioplegia group and cold crystalloid cardioplegia group. The patients in both groups were given 2 mL of central venous blood before cardiopulmonary bypass (CPB), 10 min after the aorta was blocked, 2 mL after the end of commutation, 2 h after the operation, and 12 h after the operation. The creatine kinase-isoenzyme (CK-MB) and troponin I (cTnI) concentrations were recorded. The clinical parameters (cardiopulmonary bypass time, aortic block time, postoperative ventilator aiding time, dopamine dosage at the end of surgery and after 12 h) . Results: The clinical observation indexes of CP group were better than that of the control group (P <0.05). The CK-MB and cTnI concentrations of two groups began to rise after aortic blockage and peaked at the end of commutation, with statistical difference before CPB Significance (P <0.01). Compared with the control group, the amplitude of the aorta occlusion in the experimental group at each time point was significantly lower than that of the control group (P <0.05). Conclusion: Infantile open heart surgery, the application of cardioplegia containing CP has good protective effect on infants and young children’s myocardium.