吉林大学学报(医学版) ›› 2022, Vol. 48 ›› Issue (4): 1045-1050.doi: 10.13481/j.1671-587X.20220427

• 临床医学 • 上一篇    

Del Nido停搏液在冠状动脉旁路移植术中的应用

廉海星,王巍(),林柏松,陈晨,孙雪峰,李哲   

  1. 吉林大学中日联谊医院心脏外科,吉林 长春 130033
  • 收稿日期:2022-01-21 出版日期:2022-07-28 发布日期:2022-07-26
  • 通讯作者: 王巍 E-mail:wangwei820419@jlu.edu.cn
  • 作者简介:廉海星(1993-),女,黑龙江省哈尔滨市人,在读硕士研究生,主要从事心脏外科疾病临床治疗方面的研究。
  • 基金资助:
    吉林省科技厅科技发展计划重点科技研发项目(3D518NS63430)

Application of Del Nido cardioplegic in coronary artery bypass grafting

Haixing LIAN,Wei WANG(),Baisong LIN,Chen CHEN,Xuefeng SUN,Zhe LI   

  1. Department of Cardiovascular Surgery,China-Japan Union Hospital,Jilin University,Changchun 130033,China
  • Received:2022-01-21 Online:2022-07-28 Published:2022-07-26
  • Contact: Wei WANG E-mail:wangwei820419@jlu.edu.cn

摘要: 目的

分析在单纯体外循环下冠状动脉旁路移植术中应用Del Nido停搏液的有效性及安全性,对比Del Nido停搏液与4∶1含血停搏液应用于冠状动脉旁路移植术中的心肌保护效果,为心脏停搏液的选择提供依据。

方法

选取在本院行体外循环下冠状动脉旁路移植手术的患者51例,其中应用Del Nido停搏液30例(DN组),应用含血停搏液21例(血灌组)。收集2组患者术中主动脉阻断(ACC)时间、体外循环(CPB)时间、停搏液灌注次数及总量、自动复跳情况、术中输血量、血液生化指标、手术时间和术后机械通气时间等指标,观察2组患者术后出现房颤、心肌梗死和胸骨后感染等并发症的情况。

结果

DN组和血灌组患者基线资料比较差异无统计学意义(P>0.05)。与血灌组比较,DN组患者术中停搏液灌注次数、灌注量和术中输血量均明显减少(P<0.01),自动复跳率明显升高(P<0.01)。转机前后2组患者钾离子、血糖、血红蛋白、乳酸水平和红细胞压积,术后机械通气时间、ICU住院时间、术后肌酐水平和术后并发症比较差异均无统计学意义(P>0.05)。

结论

Del Nido停搏液在冠状动脉旁路移植术中应用安全有效,心肌保护效果明确,与常规含血停搏液比较可减少停搏液灌注总量及灌注次数,复跳率更高,并且能够降低围术期输血量。

关键词: Del Nido停搏液, 冠状动脉旁路移植术, 缺血再灌注损伤, 心肌保护, 复跳率

Abstract: Objective

To analyze the efficacy and safety of Del Nido cardioplegic in coronary artery bypass grafting under extracorporeal circulation alone, and to compare the myocardial protection effect of Del Nido cardioplegic and 4∶1 blood containing cardioplegic in coronary artery bypass grafting, and to provide the reference for the selection of cardioplegic.

Methods

A total of 51 patients underwent coronary artery bypass grafting under cardiopulmonary bypass in our hospital were selected, including 30 patients received Del Nido cardioplegia (DN group) and 21 patients received blood containing cardioplegia (hemoperfusion group).The intraoperative aortic cross-clamp (ACC) time, cardiopulmonary bypass (CPB) time, the number and total amount of pleural fluid perfusion, automatic repulse, introoperative blood loss,blood biochemical index,operation time, postoperative mechanical ventilation time and other indicators of the patients in two groups were collected, and the postoperative complications such as atrial fibrillation, myocardial infarction and retrosternal infection of the patients in two groups were observed.

Results

There were no statistical differences in radix data of the patients between DN group and hemoperfusion group (P>0.05). Compared with hemoperfusion group,the number and volume of intraoperative cardioplegia and intraoperative blood transfusion demand of the patients in DN group were significantly decreased (P<0.01), and the rate of automatic resuscitation was increased(P<0.01). There were no significant differences in potassium ion, blood glucose, hemoglobin, lactic acid level, hematocrit, postoperative mechanical ventilation time, time of ICU stay, postoperative creatinine level and postoperative complications of the patients between two groups before and after transfer (P>0.05).

Conclusion

Del Nido cardioplegia is safe and effective in coronary artery bypass grafting, and has a clear myocardial protection effect. In addition, compared with conventional blood-containing cardioplegia, Del Nido cardioplegia can reduce the total amount and times of cardioplegia, have a higher repulse rate, and reduce the amount of perioperative blood transfusion.

Key words: Del Nido cardioplegia, Coronary artery bypass grafting, Ischemia reperfusion injury, Myocardial protection, Bounce rate

中图分类号: 

  • R654.1