文档介绍：康斯特保护液与晶体或含血停搏液的作用比较
【摘要】目的康斯特保护液(HTK液)作为心脏停搏液与晶体或冷血心脏停搏液作用的比较。方法应用HTK液(HTK液组)25例,晶体或冷血心脏停搏液(对照组)25例。手术种类:二尖瓣和主动脉瓣置换术,二尖瓣置换术,主动脉瓣置换术,左房粘液瘤切除术,室间隔缺损修补术,房间隔缺损修补术。灌注方法:两组麻醉方式相同,体外循环采用中度低温,鼻咽温度和肛温<30℃时阻断升主动脉,同时主动脉根部进行顺行或经冠状动脉开口直接灌注。对照组按400 ml/m2灌注心脏晶体或冷血心肌麻痹液,每30 min灌注一次;HTK液组用4℃~8℃的HTK液按30~40 ml/kg以100 mm Hg的灌注压力进行灌注并在10 min内结束,如果升主动脉阻断时间超过120 min,或出现心电活动再进行灌注。观察的指标:体外循环后心脏自动复跳率,术后应用正性肌力药物,术后监护天数。结果自发性复跳率无差别,HTK液组正性肌力药物,术后监护的天数与对照组差异明显。结论HTK液可以明显地保护心肌功能, 但是心脏自动复跳率较低与文献报道有矛盾, 这可能与这组研究的资料样本小有关,有待于进一步研究。其缺点容易造成血液稀释,尤其在婴幼儿患者,而且产品价格较昂贵限制了在临床的广泛应用。
【关键词】 HTK液;心肌保护;晶体心脏停跳液
pare the Effect of HTK and Crystalloid/Blood Cardioplegic Solution
Abstract: OBJECTIVEThe aim is pare the effect of HTK (Histidine-Triptophan-Ketoglutalate) and crystall
oid/blood cardioplegic patients were divided into two groups. HTK solution group(n=25)and crystalloid solution group(n=25).These patients undergoing open heart surgery such as DVR,MVR,AVR,LAM,VSD, moderate hypothermia 28℃~32℃of the body was maintained during CPB. In the HTK group, perfused 30~40 ml/kg in 6~8 min as a single dose, and was repeated when the cardiac electrical action crystalloid solution was perfused every 20~30 minus at 15ml/kg. The incidence of inotropic support requirement after operation,and the days stayed in the intensive care unit were aorta cross-clamping time an