心脏手术患者围术期血浆血管加压素浓度变化研究

目的通过对体外循环、不同手术方式等多因素影响围术期血浆血管加压素(AVP)浓度变化的研究,阐明其变化规律。方法选取40例体外循环心内直视手术患者作为研究对象。分别测定术前,体外循环20min,术后2h、24h、72h血浆AVP浓度,以不同术式(心脏停跳、心脏不停跳)、不同体外循环时间分组,然后进行资料统计分析。结果体外循环20min时血浆AVP浓度达高峰,术后72h恢复到术前水平;术后2h心脏停跳组显著高于心脏不停跳组;体外循环>40min组高于体外循环≤40min组。结论体外循环(CPB)是刺激机体应激反应产生AVP最强有力的诱因。术后早期血浆AVP浓度的升高程度与体外循环时间呈正相关。心脏停跳手术方式更能刺激机体在术后早期产生高水平的血浆AVP。心脏不停跳心内直视手术方式能减少对机体的损伤,减轻心肌缺血再灌注损伤。

Alteration of plasma arginine vasopressin during perioperation in patients with open heart operation

Objective in order to discribe the law of the alterations of plasma AVP during perioperation and provide theory for clinical application. Methods 40 patients undergoing heart operation were studied, 4ml blood samples were obtained at the following times: the day before surgery, 20 min after the start of CPB, 2 h, 24 h, 72 h after surgery. The data were analysised according to different operative methods, different CPB time .Results The plasma AVP concentration reached a maximum at CPB 20 min, The plasma AVP concentration 72 h after surgery was similar to that of the day before surgery AVP concen- tration of AH group and A group were higher than that of BH group and B group at 2h after surgery(P<0.05=, Conclusion The duration of surgery and CPB may be important factors in its production. the longer operation time continues, the longer CPB time continues, the higher the AVP con- centration will be at 2h after operation.