Abstract:Objective To investigate the effects of remote ischemic preconditioning(RIPC)by direct femoral artery occlusion on lung function of patients undergoing totally thoracoscopic cardiac surgery with cardiopulmonary bypass(CPB). M ethods 60 patientswith congenital heart disease underwent thoracoscopic cardiac surgery with CPB from March 2015 to May 2016 were selected and divided into the research group(group R)and the control group(group C),30 cases in each group.After the femoral artery and vein were dissociated,group C was established CPB through the intubation directly.Group R was clamped and closed femoral artery 3 min,then open 3 min,After three cycles,the samemethod in the group Cwasused to establish CPB.Through three hole shape incision at the right chestwall,that each was 1.5 to 2.0 cm long in the third,fourth and sixth intercostals surgical field was revealed totally by thoracoscope to complete the operation.The radial artery blood was collected after tracheal intubation for 5min(T0),after cessation of CPB for 2 hours(T1),after cessation of CPB 12 hours(T2)and after cessation of CPB 24 hours(T3).Oxygenation index was recorded by blood gas analysis.The receptor of advanced glycation end-products(RAGE)level was detected by enzyme linked immunosorbent assay(ELISA).Results 60 patientswere all cured.Therewas no significant difference in themechanical ventilation time between the two groups(P>0.05).There was no significant difference in oxygenation index between the two groups in T0point(P>0.05).The oxygenation index of the two groups of T1-T3were all decreased.The oxygenation index of group R in T1-T3pointswas higher than that of group C at the same time,with significant difference(P<0.05).There was no significant difference in the level of RAGE between the two groups in T0point(P>0.05).The level of plasma RAGE were increased in the two groups in T1-T3points.The level of plasma RAGE of group R in T1-T3pointswas lower than that of group C at the same time,with significant difference(P<0.05).Conclusion RIPC by femoral artery occlusion can decrease the level of RAGE in patients underwent thoracoscopic cardiac surgery with CPB and has lung protective effects.
杨晓涵;于洪涛;张锐;李涯. 远程缺血预处理对全胸腔镜体外循环手术的肺保护作用[J]. 中国当代医药, 2016, 23(21): 43-45转49.
YANG Xiao-han;YU Hong-tao;ZHANG Rui;LIYa. Lung protective effect of rem ote ischem ic preconditioning on totally thoracoscopic cardiac surgery w ith cardiopulmonary bypass. 中国当代医药, 2016, 23(21): 43-45转49.
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