4∶1含血停搏液与组氨酸-色氨酸-酮戊二酸液在心脏瓣膜置换术中的应用效果

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Abstract Objective To investigate the application effect of 4∶1 blood cardioplegic fluid and domestic histidine -tryptophan-ketoglutaric acid(HTK)in cardiac valve replacement.Methods A retrospective analysis was performed on the clinical data of 64 patients undergoing cardiac valve replacement under extracorporeal circulation in Qingyuan People's Hospital from February 2018 to December 2020.The patients were divided into group H and group G according to the different use of myocardial protective fluid during cardiopulmonary bypass aorta occlusion,with 32 cases in each group.Patients in group H were treated with a single infusion of domestic HTK liquid as myocardial protective fluid to induce cardiac arrest,and patients in group G were treated with multiple perfusion of 4∶1 blood cardioplegia fluid.Blood gas indexes,electrolyte concentration,mean arterial pressure(MAP)and perioperative indexes before transfer after induction of anesthesia(T1),10 min after transfer(T2),10 min after aorta blocking infusion of stopper fluid(T3),5 min after cardiopulmonary bypass rewarming(T4),10 min after aortic opening at min(T5)and after shutdown(T6)were compared between the two groups of patients.Results There were no significant differences in blood gas pH value between the two groups at different time(P＞0.05).|BE| value of group H at T3,T4 and T5 moment were higher than those of the group G,the differences were statistically significant(P＜0.05).Lac in group H at T3 was lower than that in group G,Lac at T4 and T5 were higher than those in group G,the differences were statistically significant(P＜0.05).Carbon dioxide partial pressure(PaCO2)at T5 in group H was higher than that in group G,the difference was statistically significant(P＜0.05).Electrolyte K+concentration at T4 in group H was lower than that in group G,the difference was statistically significant(P＜0.05).The HCT value of group H at T3 and T4 were lower than those of group G,and the differences were statistically significant(P＜0.05).The MAP of group H at T5 was lower than that of group G,the difference was statistically significant(P＜0.05).In group H,PaCO2,HCT and MAP values at T2,T3,T4,T5 and T6 were lower than those at T1,Lac values at T4,T5 and T6 were higher than those at T1,and K+ concentrations at T3,T4,T5 and T6 were higher than those at T1,the differences were statistically significant(P＜0.05).PaCO2 and HCT values of patients at T2,T3,T4,T5 and T6 in group G were lower than T1,K+concentration at T3,T4,T5 and T6 were higher than T1,MAP value at T2,T3,T5 and T6 were lower than T1,Lac value at T4,T5 and T6 were higher than T1,the differences were statistically significant(P＜0.05).There were no significant differences in operation time,ICU stay time and incidence of postoperative complications between the two groups(P＞0.05).The time of cardiopulmonary bypass in group H was shorter than that in group G,and the amount of cardiopulmonary bypass was lower than that in group G,the differences were statistically significant(P＜0.05).Conclusion The use of 4∶1 blood containing cardiopulmonary bypass solution and home-made HTK fluid during valve replacement with cardiopulmonary bypass has less influence on the internal environment of patients.

Key words： Cardiac valvular disease；Cardiopulmonary bypass Histidine-tryptophan-copper glutarate Blood gas analysis Mean arterial pressure

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	Articles by authors
	GONG Jianping
	LIANG Xiusheng
	LI Weichao
	LIU Yuyan
	LENG Binghua
	CHEN Guomin
	LI Heng

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GONG Jianping,LIANG Xiusheng,LI Weichao, et al. Application effect of 4∶1 blood cardioplegia and histidine-tryptophan-ketoglutarate solution in cardiac valve replacement[J]. 中国当代医药, 2022, 29(10): 14-19.

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https://www.dangdaiyiyao.com/EN/ OR https://www.dangdaiyiyao.com/EN/Y2022/V29/I10/14

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