不同心肌保护方法在双瓣膜置换术中对心肌的保护效果评价

目的 分析不同心肌保护方法 在双瓣膜置换术中对心肌的保护效果评价. 方法 整群选取90例行双瓣膜置换术的患者随机分为顺行灌注组、逆行灌注组、顺行+逆行灌注组,各30例,比较3组相关观察指标. 结果 顺行灌注、逆行灌注及联合灌注组乳酸浓度分别为(14.8±1.2)、(17.5±1.2)、(14.6±1.2);血清CK-MB 分别为(63.2±25.5)、(78.3± 21.3)、(66.7±19.1)U/L;血清cTnl分别为(1.4±0.3)、(1.8±0.5)、(1.4±0.2)ng/mL;顺行及联合灌注组患者心肌乳酸浓度低于逆行灌注组(P<0.05);顺行灌注组及联合灌注组磷酸肌酸激酶同工酶及血清心肌肌钙蛋白I浓度均显著低于逆行灌注组(P<0.05). 结论 顺行灌注、逆行灌注及联合灌注保护心肌均具有一定的效果,顺行及联合灌注效果更佳,顺行灌注操作更加简单.

Evaluation of Protective Effect of Different Myocardial Protection Methods in the Double Valve Replacement

Objective To analyze the evaluation of protective effect of different myocardial protection methods in the double valve replacement. Methods 90 cases of patients receiving double valve replacement were randomly divided into retrograde perfusion group ,etrograde perfusion group and retrograde AND etrograde perfusion group with 30 cases in each, the related observation indicators of the three groups were compared. Results The arterial lactate concentration of the three groups was respectively (14.8±1.2),(17.5±1.2)and(14.6±1.2);the serum CK-MB of the three groups was respectively (63.2±25.5)U/L, (78.3±21.3)U/L and (66.7±19.1)U/L, the serum cTnl of the three groups was respectively (1.4±0.3)ng/ml,(1.8±0.5)ng/ml and (1.4±0.2)ng/ml, the myocardial arterial lactate concentration in the retrograde perfusion group and combined perfusion group was lower than that in the etrograde perfusion group P<0.05, the creatine kinase isoenzyme and serum cardiac tro-ponin I concentration in the retrograde perfusion group and combined perfusion group were obviously lower than those in the etrograde perfusion group P<0.05. Conclusion Retrograde perfusion, etrograde perfusion and combined perfusion in protecting myocardium all have a certain effect, the retrograde perfusion and combined perfusion has a better effect and ret-rograde perfusion is easier.