Experiment studies of tumor necrosis factor changes in different tissues after stimulating vagus nerve

AIM：To investigate the effect of proinflammatory cytokine and anti-infalammatation cytokine on liver and lung tissues in rats with endotoxemia.METHODS:Male Wistar rats were randomly divided into 4 groups:group treated with stimulating vagus nerve,group receiving lipopolysaccharide (LPS) intravenous injection after transecting vagus nerve,group treated with sham operation and group treated with injecting LPS intravenously alone,and then measured the levels of TNF-α in liver and lung and those of cortisol and Alanine aminotransferase(ALT) in plasma.RESULTS:Compared with group treated with sham operation,LPS-treated groups showed a significant increase in TNF level,which was at most 15 fold higher than that of the former group.There was a significant decrease in TNF level in group treated with stimulating vagus nerve,compared with both group receiving LPS intravenous injection after transecting vagous nerve and group treated only with LPS.In addition,we observed plasma cortisol level in LPS-treated group was much higher than other 3 groups and the plasma ALT level was greatly lower than that of group treated only with LPS.CONCLUSION:Stimulating vagous nerve can significantly decrease the production of proinflammatory cytokine and alleviate inflammation in rats with endotoxemia.     

系统管理对早产儿脑瘫早期诊断和干预效果的评价

目的 评价早产儿定期随访、系统管理对早期发现脑瘫及早期干预的效果.方法 以我院早教门诊发现的50例脑瘫早产儿作为研究组,普通门诊就诊发现的40例脑瘫早产儿为对照组,研究组给予系统定期随访、系统干预,对照组行非系统随访.在治疗年龄及治疗效果上进行对比分析.结果 (1)研究组治疗年龄(4.0±1.2)月,对照组(7.0±1.4)月(P＜0.05).(2)1岁时研究组心理发育指数(MDI)为91.8±10.2,运动发育指数(PDI)为90.2±11.2,对照组的MDI为80.2±11.7、PDI为79.3±10.2,2组比较差异均有统计学意义(P均＜0.05).结论 系统管理有助于及时发现早产儿脑瘫,并可促进早产儿身心发育.

Abstract：

Objective To evaluate the effects of regular follow-up and systematic management in premature infants on early discovering of cerebral palsy and intervention efficacy in early phase. Methods Fifty premature infants with cerebral palsy recruited from early children development outpatient service, were classified as treatment group; 40 premature infants with cerebral palsy recruited from general outpatient service, were classified as control group. The infants of treatment group received systematic follow-up and intervention. while the infants of control group received no systematic management. Age and therapeutic efficacy were compared between the two groups. ResultsThe average age in the treatment group ( [4. 0 ± 1.2] months) was significantly younger than that of the control group ( [7.0 ± 1.4] months) ( P ＜ 0. 05 ). The mental development index ( MDI )and physical development index (PDI) in the treatment group was 91.8 ± 10. 2 and 90. 2 ± 11.2,respectively,which were significantly higher than that of the control group(80. 2 ± 11.7 for MDI and 79. 3 ± 10. 2 for PDI)( P ＜ 0. 05 ) . Conclusion Systematic management could help discover cerebral palsy in premature infants in time and could improve physical and mental development of these infants.     

STA无痛注射仪在口腔局部浸润麻醉中的应用

目的 探讨计算机控制下的口腔无痛注射仪(Single Tooth Anesthesia,STA)在口腔颌面外科局部浸润麻醉中的无痛效果、护理特点以及应用前景.方法 将120例行局部浸润麻醉的拔牙患者随机分为两组,使用STA注射仪注射为实验组,使用传统手动注射器注射为对照组.在注射过程中使用心率监测仪监测两组患者的心率.通过比较两组患者注射后的疼痛视觉模拟评分(VAS)以及注射前、注射中的心率变化来评价注射的疼痛程度.结果 两组患者VAS评分结果 显示88.3%的实验组患者评价注射为无痛或轻微疼痛,而对照组中80%患者评价为中等以上疼痛.实验组患者注射中的心率较注射前显著性下降(P＜0.05),而对照组患者注射前、注射中心率无统计学差异.结论 STA能降低患者的疼痛,减少患者在拔牙术前的紧张感,从而配合医生的操作,使治疗得以顺利进行.

Abstract：

Objective To explorer the effects of the STATM anesthetic delivery system in oral local infiltration anesthesia , nursing characteristics and its application prospect. Methods One hundred and twenty patients undergoing pre-orthodontic extraction were randomly divided into two groups. The STATM was used in experimental group and in the control group the traditional hand injection was performed. After each injection, patients evaluated pain during needle insertion and injection with visual analog scale. The heart rates of the patients were recorded before and during injection. Results Statistical analysis indicated that the STATM group had a lower VAS value than the control group. During injection, the heart rates of the STATM group decreased significantly compare with the control group ( P ＜ 0. 05 )Conclusions The STATM system can reduce the pain during the needle injection and anesthetic delivery, and decrease the tension before dental extraction.     

饮食教育预防骨科术后病人便秘的研究

Objective To study the effect of diet education on preventing constipation among orthopedic inpafients, and the relationship between diet education and food - taking pattern of postoperative pa-tients. Methods 97 orthopedic inpafients who have been operated on spine were randomly divided into experimen-tal group (n =48) and control group (n = 49) . Patients in experimental group were given diet education at the operation day and second day after operation. Patients in control group were given routine intervention. The sorts and amounts of food taken in the three days after operation and defecation score were collected. Results The rate of vegetable taken by patients in the second and third day after operation in experimental group was higher than that in control group(X<'2> =6.95;7. 24;all P <0.05) ;The amount of staple food taken by patients at the first and sec-ond day after operation in experimental group was higher than that in control group (t= 2.077 ;3. 084;all P <0.05) ;The amount of vegetable taken by patients at the second and third day after operation in experimental group was higher than that in control group (t=0.025 ;2.341 ;all P<0.05 ). Defecation score of patients in experimental group (6.85±3.32) was lower than that of control group(8.63±3.27 ), (t=2.66 P<0.05 ). Conclusions Di-et education can prevent constipation of these patients after operation. The inadequate amount of staple food and vegetable were the main unreasonableness that exists among these patients. So the adequate amount of staple food and vegetable should be emphasized when diet education is given and we should take the condition of patients tak-ing food more serious in three days after operation.     

饮食教育预防骨科术后病人便秘的研究

Objective To study the effect of diet education on preventing constipation among orthopedic inpafients, and the relationship between diet education and food - taking pattern of postoperative pa-tients. Methods 97 orthopedic inpafients who have been operated on spine were randomly divided into experimen-tal group (n =48) and control group (n = 49) . Patients in experimental group were given diet education at the operation day and second day after operation. Patients in control group were given routine intervention. The sorts and amounts of food taken in the three days after operation and defecation score were collected. Results The rate of vegetable taken by patients in the second and third day after operation in experimental group was higher than that in control group(X<'2> =6.95;7. 24;all P <0.05) ;The amount of staple food taken by patients at the first and sec-ond day after operation in experimental group was higher than that in control group (t= 2.077 ;3. 084;all P <0.05) ;The amount of vegetable taken by patients at the second and third day after operation in experimental group was higher than that in control group (t=0.025 ;2.341 ;all P<0.05 ). Defecation score of patients in experimental group (6.85±3.32) was lower than that of control group(8.63±3.27 ), (t=2.66 P<0.05 ). Conclusions Di-et education can prevent constipation of these patients after operation. The inadequate amount of staple food and vegetable were the main unreasonableness that exists among these patients. So the adequate amount of staple food and vegetable should be emphasized when diet education is given and we should take the condition of patients tak-ing food more serious in three days after operation.     

饮食教育预防骨科术后病人便秘的研究

Objective To study the effect of diet education on preventing constipation among orthopedic inpafients, and the relationship between diet education and food - taking pattern of postoperative pa-tients. Methods 97 orthopedic inpafients who have been operated on spine were randomly divided into experimen-tal group (n =48) and control group (n = 49) . Patients in experimental group were given diet education at the operation day and second day after operation. Patients in control group were given routine intervention. The sorts and amounts of food taken in the three days after operation and defecation score were collected. Results The rate of vegetable taken by patients in the second and third day after operation in experimental group was higher than that in control group(X<'2> =6.95;7. 24;all P <0.05) ;The amount of staple food taken by patients at the first and sec-ond day after operation in experimental group was higher than that in control group (t= 2.077 ;3. 084;all P <0.05) ;The amount of vegetable taken by patients at the second and third day after operation in experimental group was higher than that in control group (t=0.025 ;2.341 ;all P<0.05 ). Defecation score of patients in experimental group (6.85±3.32) was lower than that of control group(8.63±3.27 ), (t=2.66 P<0.05 ). Conclusions Di-et education can prevent constipation of these patients after operation. The inadequate amount of staple food and vegetable were the main unreasonableness that exists among these patients. So the adequate amount of staple food and vegetable should be emphasized when diet education is given and we should take the condition of patients tak-ing food more serious in three days after operation.     

饮食教育预防骨科术后病人便秘的研究

Objective To study the effect of diet education on preventing constipation among orthopedic inpafients, and the relationship between diet education and food - taking pattern of postoperative pa-tients. Methods 97 orthopedic inpafients who have been operated on spine were randomly divided into experimen-tal group (n =48) and control group (n = 49) . Patients in experimental group were given diet education at the operation day and second day after operation. Patients in control group were given routine intervention. The sorts and amounts of food taken in the three days after operation and defecation score were collected. Results The rate of vegetable taken by patients in the second and third day after operation in experimental group was higher than that in control group(X<'2> =6.95;7. 24;all P <0.05) ;The amount of staple food taken by patients at the first and sec-ond day after operation in experimental group was higher than that in control group (t= 2.077 ;3. 084;all P <0.05) ;The amount of vegetable taken by patients at the second and third day after operation in experimental group was higher than that in control group (t=0.025 ;2.341 ;all P<0.05 ). Defecation score of patients in experimental group (6.85±3.32) was lower than that of control group(8.63±3.27 ), (t=2.66 P<0.05 ). Conclusions Di-et education can prevent constipation of these patients after operation. The inadequate amount of staple food and vegetable were the main unreasonableness that exists among these patients. So the adequate amount of staple food and vegetable should be emphasized when diet education is given and we should take the condition of patients tak-ing food more serious in three days after operation.     

饮食教育预防骨科术后病人便秘的研究

Objective To study the effect of diet education on preventing constipation among orthopedic inpafients, and the relationship between diet education and food - taking pattern of postoperative pa-tients. Methods 97 orthopedic inpafients who have been operated on spine were randomly divided into experimen-tal group (n =48) and control group (n = 49) . Patients in experimental group were given diet education at the operation day and second day after operation. Patients in control group were given routine intervention. The sorts and amounts of food taken in the three days after operation and defecation score were collected. Results The rate of vegetable taken by patients in the second and third day after operation in experimental group was higher than that in control group(X<'2> =6.95;7. 24;all P <0.05) ;The amount of staple food taken by patients at the first and sec-ond day after operation in experimental group was higher than that in control group (t= 2.077 ;3. 084;all P <0.05) ;The amount of vegetable taken by patients at the second and third day after operation in experimental group was higher than that in control group (t=0.025 ;2.341 ;all P<0.05 ). Defecation score of patients in experimental group (6.85±3.32) was lower than that of control group(8.63±3.27 ), (t=2.66 P<0.05 ). Conclusions Di-et education can prevent constipation of these patients after operation. The inadequate amount of staple food and vegetable were the main unreasonableness that exists among these patients. So the adequate amount of staple food and vegetable should be emphasized when diet education is given and we should take the condition of patients tak-ing food more serious in three days after operation.     

饮食教育预防骨科术后病人便秘的研究

Objective To study the effect of diet education on preventing constipation among orthopedic inpafients, and the relationship between diet education and food - taking pattern of postoperative pa-tients. Methods 97 orthopedic inpafients who have been operated on spine were randomly divided into experimen-tal group (n =48) and control group (n = 49) . Patients in experimental group were given diet education at the operation day and second day after operation. Patients in control group were given routine intervention. The sorts and amounts of food taken in the three days after operation and defecation score were collected. Results The rate of vegetable taken by patients in the second and third day after operation in experimental group was higher than that in control group(X<'2> =6.95;7. 24;all P <0.05) ;The amount of staple food taken by patients at the first and sec-ond day after operation in experimental group was higher than that in control group (t= 2.077 ;3. 084;all P <0.05) ;The amount of vegetable taken by patients at the second and third day after operation in experimental group was higher than that in control group (t=0.025 ;2.341 ;all P<0.05 ). Defecation score of patients in experimental group (6.85±3.32) was lower than that of control group(8.63±3.27 ), (t=2.66 P<0.05 ). Conclusions Di-et education can prevent constipation of these patients after operation. The inadequate amount of staple food and vegetable were the main unreasonableness that exists among these patients. So the adequate amount of staple food and vegetable should be emphasized when diet education is given and we should take the condition of patients tak-ing food more serious in three days after operation.     

改良超滤对婴儿体外循环心脏直视手术肺保护作用的研究

目的 探讨改良超痣对婴幼儿体外循环心脏直视手术肺保护的作用.方法 随机抽取2004年5月至2009年2月我院310例(年龄≤1岁,体重≤10 kg)行体外循环心脏直视手术患儿,分为改良超滤组(260例)和对照组(常规并行超滤50例),比较2组体外循环结束时、超滤开始时(或体外循环结束5 min)、超滤结束时(或体外循环结束20 min)和术后1、6 h气道峰压(Ppeak)、气道平台压(Pplate)及肺顺应性(CL)、氧合指数、肺水含量(TAF),比较2组术后呼吸机辅助通气时间.结果 改良超滤组Ppeak、Pplate及TAF在改良超滤后较对照组各时点明显下降(P<0.05),CL及氧合指数则明显增高(P<0.05);改良超滤组在超滤结束时(或体外循环结束20 min)、术后1、6 h各时点Ppeak、Pplate及TAF较对照组明显下降(P均<0.05);CL及氧合指数较对照组明显升高(P均<0.05);改良超滤组呼吸机辅助通气时间(5.9±2.3)h较对照组(9.3±2.0)h明显缩短(P<0.05).结论 改良超滤可明显改善体外循环后呼吸功能,是良好的耍幼儿体外循环心脏直视手术肺保护方法之一.     

牛磺酸对婴幼儿体外循环肺损伤的保护作用

目的探讨牛磺酸对婴幼儿体外循环（CPB）术后肺损伤的保护作用。方法先天性心脏病择期手术患儿80例被选择性的分为对照组（C组）和试验组（T组）。C组不给药,T组于术前7 d口服牛磺酸15.5 mg/（kg.d）,于术后2 h、6 h、12 h和24 h不同时间点,抽取桡动脉血测氧合指数（OI）。应用纤维支气管镜进行肺泡灌洗,收集肺泡灌洗液,检测肺泡灌洗液中总磷脂（TPL）、饱和磷脂酰胆碱（Sat-PC）、总蛋白（TP）,以Sat-PC/TPL和Sat-PC/TP作为判断肺表面活性物质（PS）活性水平的指标;计算肺通透指数（LPI）。结果 OI：CPB结束后6 h开始升高。与C组比较,T组CPB后6 h、12 h、24 h明显增高（P〈0.05）;PS的活性指标：T组手术后较C组的Sat-PS/TPL和Sat-PS/TP均降低（P〈0.05）;LPI：T组LPI显著低于C组（P〈0.05）。结论牛磺酸可通过改善肺的肺通透性和PS活性水平,提高氧合指数,对婴幼儿CPB诱发的肺损伤起一定的保护作用。     

Anti-CD18 antibodies improve cardiac function following cardiopulmonary bypass in dogs

Cardiopulmonary bypass is associated with activation of neutrophils, which may adhere to vascular endothelium causing lung, heart, and brain injury. We tested whether blocking neutrophil adherence would improve organ function following cardiopulmonary bypass in dogs.

Ulbar|Materials and Methods: All dogs received a standard anesthetic, and then one group (n = 6) received 2 hours of cardiopulmonary bypass followed by 4 hours of observation. A second group (n = 6) received a monoclonal antibody (6 mg/kg) to CD18, a neutrophil adherence factor, immediately before cardiopulmonary bypass. A third group (n = 6) did not receive cardiopulmonary bypass or antibody.

Using flow cytometry we found that the antibody bound essentially all neutrophil CD18 sites. All three groups had similar gas exchange and hemodynamics. Lung and heart histology results were similar between groups. By echocardiography, five animals receiving cardiopulmonary bypass alone showed regional wall abnormalities, whereas only one receiving antibody showed wall motion abnormality (P < .05). Following cardiopulmonary bypass, intracellular myocardial pH was higher (P < .05) in the antibody-treated group compared with the group that had cardiopulmonary bypass alone (7.23 ± 0.05 v 7.07 ± 0.07 respectively).

Monoclonal antibodies to CD18 can prevent the deterioration in cardiac function routinely observed following cardiopulmonary bypass.     

人工瓣膜置换体外循环过程中痰热清注射液的肺保护

背景：体外循环心内直视术不可避免会造成肺损伤,近年来临床上已有中医药应用于该领域减轻肺损伤的研究。目的：观察痰热清注射液对机械瓣置换患者体外循环肺损伤的保护效果。方法：心脏瓣膜置换患者40例随机分为2组,痰热清组患者于术前晚、体外循环前分别予以痰热清注射液20mL入250mL生理盐水静脉滴注,对照组予以生理盐水250mL静滴。于体外循环前、体外循环40min、体外循环停机、停机后2,6,24h共6个不同时间点抽取桡动脉血2mL,全血细胞分析仪测定中性粒细胞数量;双抗体夹心ELISA法测定可溶性细胞间黏附因子1、白细胞介素8血浆浓度。并于体外循环前、体外循环停机时取左右心房血测中性粒细胞并计算跨肺差值。于瓣膜置换切皮前、体外循环结束后10min、瓣膜置换结束时、瓣膜置换结束后4h4个时相计算两组患者的呼吸指数与肺动态顺应性。结果与结论：两组患者体外循环后各个时间点中性粒细胞值、可溶性细胞黏附因子1、白细胞介素8较体外循环前明显升高（P〈0.01）,痰热清组明显低于对照组（P〈0.01）。体外循环停机时中性粒细胞跨肺差值明显高于体外循环前（P〈0.01）,痰热清组明显低于对照组（P〈0.01）。两组呼吸指数较瓣膜置换切皮前明显升高（P〈0.01）,肺动态顺应性较体外循环前明显降低（P〈0.01）,瓣膜置换结束后4h恢复至切皮前水平（P〉0.05）,痰热清组呼吸指数较对照组降低（P〈0.05）,肺动态顺应性瓣膜置换结束时较对照组升高（P〈0.01）。提示痰热清注射液能减轻机械瓣置换后的肺损伤,有较好的肺保护效果。     

升主动脉注射鱼精蛋白对体外循环后C3a和C5a的影响

目的观察和评价通过升主动脉及上腔静脉注射鱼精蛋白不同注射途径对体外循环后婴儿血浆C3a、C5a的影响。方法年龄≤12个月行体外循环心内直视手术的患儿60例,应用随机数字表法随机分为实验组30例（经升主动脉注射鱼精蛋白组）和对照组30例（经腔静脉注射鱼精蛋白组）。于注射鱼精蛋白前（T1）、注射鱼精蛋白后1h（T2）取右心房肝素抗凝血1ml,用ELISA法测定血浆C3a、C5a浓度。结果实验组患儿注射鱼精蛋白前后血浆C3a浓度[（18．762±3．792）μg/L与（19．554±3．453）μg/L,t=-0．846,P=0．20]、C5a浓度[（0．843±0．159）μg/L与（0．825±0．119）μg／L,t=0．496,P=0．31],差异均无统计学意义（P均〈0．05）;对照组患儿注射鱼精蛋白前后血浆C3a浓度[（18．780±3．864）μg／L与（22．961±3．501）μg/L,t=-4．392,P〈0．01]、C5a浓度[（0．839±0．157）μg／L与（0．979±0．116）μg／L,t=-3．928,P〈0．01]均显著增高。注射鱼精蛋白后1h对照组患儿血浆C3a浓度较实验组显著增高[（22．961±3．501）μg／L与（19．554±3．453）μg/L,t=-3．795,P〈0．01]、C5a浓度亦较实验组显著增高[（0．979±0．116）μg/L与（0．825±0．119）μg／L,t=-5．075,P〈0．01]。结论升主动脉途径注射鱼精蛋白可显著减少体外循环后婴儿血浆C3a、C5a浓度。     

体外循环心脏直视术中鱼精蛋白毒性反应的临床防治

目的：探讨体外循环心脏直视术中鱼精蛋白毒性反应的临床特点及防治对策，方法：回顾性分析连续1727体外循环心脏直视术病例，参照Oe及Weiler标准将其分为有反应组（鱼精蛋白毒性反应组）和无反应组，并将有反应组分为轻度和中重度反应组，分析其临床特点，结果：发生鱼精蛋白毒性反应者43例，发生率2．48％，其中轻度反应者35例（81．39％，35／43），中重度反应者8例（18．61％，8／43），有反应组与反应组临床一般情况无明显差别，中重度反应组转流时间及反应持续时间明显较轻度反应组长（P＜0．05）。中重度反应组死亡2例。结论：体外循环心脏直视术中鱼精蛋白毒性反应的发生难以预料；中重度反应者后果严重；临床上应充分认识鱼精蛋白毒性反应的特点，对转流时间较长的患者的应高度警惕鱼精蛋白毒性反应的发生；低浓度缓慢静脉给药可减少毒性反应的发生，发生严重毒性反应者应立即停药，迅速肝素化并再转机辅助循环，有利于对中重度毒性反应的救治。     

降钙素原在婴幼儿体外循环术后感染监测中价值

目的探讨婴幼儿先天性心脏病（先心病）体外循环术后早期发生呼吸道细菌感染患儿围术期降钙素原的变化。方法 30例在心脏术后早期发生呼吸道细菌感染的先心病患儿（感染组）及30例未发生感染的先心病患儿（非感染组）于体外循环前、体外循环结束、术后24,48h分别检测血浆降钙素原水平。结果 2组体外循环结束时、术后24,48h血浆降钙素原水平明显高于体外循环前（P〈0.05）;感染组术后24,48h血浆降钙素原水平明显高于非感染组与本组体外循环结束时（P〈0.05）。结论心脏术后早期发生呼吸道细菌感染婴幼儿的血浆降钙素原水平增高,有助于临床更早的鉴别出高危患者,提高疗效。     

心内直视术中应用不同剂量鱼精蛋白拮抗肝素的临床对比分析

目的：通过临床对比研究心内直视术中不同剂量鱼精蛋白拮抗肝素，为低剂量鱼精蛋白使用的合理性提供依据。方法：比较1105例心内直视术中用传统剂量鱼精蛋白拮抗肝素患者（回顾性调查）和1000例用低剂量鱼精蛋白拮抗肝素患者（前瞻性研究）的鱼精蛋白毒副反应、术后出血和输血量、肝素反跳现象、追加鱼精蛋白情况和围体外循环期白陶土激活的的激活凝血时间（ACT）变化趋势。结果：传统剂量组的鱼精蛋白毒副反应发生率（4．8％）显著高于低剂量组（3．0％），P〈0．05；两组病人围体外循环期ACT变化趋势、追加鱼精蛋白情况、术后引流量、输血量和肝素反跳率无显著差别（P〉0．05）。结论：体外循环结束后降低拮抗肝素的鱼精蛋白剂量可显著减少鱼精蛋白毒副反应，不但能有效逆转肝素抗凝，且并不增加术后非外科性出血和输血量，是一种合理的鱼精蛋白拮抗肝素的方法。     

Dexamethasone reduces postoperative troponin levels in children undergoing cardiopulmonary bypass

OBJECTIVE: We previously demonstrated that dexamethasone treatment before cardiopulmonary bypass in children reduces the postoperative systemic inflammatory response. The purpose of this study was to test the hypothesis that dexamethasone administration before cardiopulmonary bypass in children correlates with a lesser degree of myocardial injury as measured by a decrease in cardiac troponin I release. DESIGN: A prospective, randomized, double-blind study. SETTING: The cardiac surgery operating room and intensive care unit of a pediatric referral hospital. SUBJECTS: Twenty-eight patients who underwent open-heart surgery for congenital heart defects. INTERVENTIONS: Patients received either placebo (group I, n = 13) or dexamethasone, 1 mg/kg iv (group II, n = 15), 1 hr before initiation of cardiopulmonary bypass. Plasma cardiac troponin I samples were obtained at three time points: immediately before study agent (sample 1), 10 mins after protamine sulfate administration after cardiopulmonary bypass (sample 2), and 24 hrs postoperatively (sample 3). MEASUREMENTS AND MAIN RESULTS: Mean cardiac troponin I levels (+/-sd) were significantly lower at sample time 3 in group II (dexamethasone; 33.4 +/- 20.0 ng/mL) vs. group I (control; 86.9 +/- 81.1) (p =.04). CONCLUSION: Dexamethasone administration before cardiopulmonary bypass in children resulted in a significant decrease in cardiac troponin I levels at 24 hrs postoperatively. We postulate that this may represent a decrease in myocardial injury, and, thus, a possible cardioprotective effect produced by dexamethasone.     

含乌司他丁自体冷血心脏停搏液对婴儿心脏直视术后心功能的影响

目的探讨含乌司他丁自体冷血心脏停搏液对婴儿体外循环心脏直视手术心功能的影响。方法年龄≤10个月行体外循环室间隔缺损修补术的患儿60例,应用随机数字表法随机分成自体冷血停搏液组30例（A组）、含乌司他丁冷血停搏液组30例（B组）。分别于主动脉开放后1、6h测量左心做功指数（LCWI）、心脏指数（CI）及每搏指数（sI）,监测术中心脏复跳时间及复跳率,正性肌力药物依赖情况。结果两组自主复跳率差异无统计学意义（P〉0．05）;B组心脏自动复跳时间[（34．2±4．7）s]及正性肌力药物依赖[40．0％（12／30）]均明显低于A组（52．1±6．5）s和66．7％（20／30）,差异有统计学意义（t=2．001、t=1．895,P均〈0．05）;B组术后不同时点CI及SI、LCWI高于A组,差异有统计学意义（P均〈0．05）。结论含乌司他丁自体冷血停搏液利于婴儿体外循环直视手术后心脏功能恢复,对未成熟心肌有良好的保护作用。