参附注射液在心脏手术中对心肌的保护作用

作者	单位
杨国锋	福建医科大学附属协和医院福建胸心外科研究所福州350001
廖崇先	福建医科大学附属协和医院福建胸心外科研究所福州350001
陈良万	福建医科大学附属协和医院福建胸心外科研究所福州350001
陈道中	福建医科大学附属协和医院福建胸心外科研究所福州350001
叶建熙	福建医科大学附属协和医院福建胸心外科研究所福州350001

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中文摘要:

目的 :探讨参附注射液 (简称参附 )在体外循环心脏手术中对心肌细胞的保护作用。方法 :38例心脏瓣膜病手术患者随机分为对照组和试验组 ,对照组经升主动脉根部首剂灌注冷晶体高钾停跳液 ,阻断心跳后 2 0min开始每隔 30min灌注含血停跳液 ,试验组则于含血停跳液基础上加入参附 2 0ml/L ,其他处理两组相同。从心肌酶谱 (CK MB、LDHI1)等方面观察参附对心肌的影响。结果 :两组患者心肌酶的改变在体外循环 (CPB)转机前差异无显著性 ,开放升主动脉后显著升高 ,但试验组明显低于对照组 ,两组间差异有显著性。结论 :参附加入含血停跳液中可加强心肌保护 ,减少心肌酶的释放 ,对心肌的保护效果优于单纯含血停跳液。

英文摘要:

Objective: To study the myocardial protective effect of Shengfu Jnjection (SFI) in patients who were undergoing open heart operation. Methods: Thirty eight patients with valvular heart diseases were randomly divided into the control and the tested group. To the patients in the control group, cold crystal hyperpotassium cardio arresting liquid was infused through ascending aorta at initial time, after blood flow being blocked for 20 min, the blood contained cardio arresting liquid was infused every 30 min. To the patients in the tested group, SFI 20 ml/L was also infused in combining with the blood containing cardio arresting liquid at the same time additionally. The two groups were treated in the same way in other aspects. Influence of SFI on myocardial enzyme spectrum (CK MB, LDHI 1) was observed. Results: The changes of myocardial enzyme spectrum in the two groups were not different significantly before operation. They increased obviously after opening the ascending aorta, but the level of increasing in the tested group was much lower than that in the control group, with statistical significance. Conclusion: Myocardial protection may be reached during open heart operation by adding SFI into the blood containing cardio arresting liquid, which could reduce the releasing of myocardial enzyme, so, the mixed liquid shows a myocardial protection effect superior to the simple one.

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