长托宁对小儿浅低温体外循环下不停跳心内直视术中微循环影响的探讨

发布时间：2018-01-02 05:24

  本文关键词：长托宁对小儿浅低温体外循环下不停跳心内直视术中微循环影响的探讨　出处：《广西医科大学》2013年硕士论文　论文类型：学位论文

  更多相关文章： 心脏不停跳心内直视术 体外循环 小儿 微循环 盐酸戊乙奎醚

【摘要】：目的：观察盐酸戊乙奎醚(Penehyclidine Hydrochloride, PHD),又称长托宁,在小儿浅低温体外循环下不停跳心内直视术中对微循环功能的影响。 方法：择期在浅低温体外循环下行不停跳房间隔缺损(ASD)修补术或室间隔缺损(VSD)修补术的先天性心脏病患儿40例,根据住院号随机分为长托宁组(P组)20例和对照组(C组)20例。两组病例均予常规心脏手术麻醉及体外循环管理,P组在预充液中加入长托宁0.02mg/kg, C组予等量生理盐水。两组均为浅低温不停跳心内直视手术,即均在维持心脏跳动状态完成手术。分别于麻醉诱导完成时(T0),中心温度(肛温)降温至33℃时(T1),体外循环结束时(T2),手术结束时(T3),手术结束后1小时(T4)五个时间点抽取动脉血检测动脉血乳酸值(Lac)。体外循环复温时记录鼻咽温及肛温复温时间。体外循环全程记录指脉氧饱和度(SpO2),心率(HR),尿量,平均动脉压(MAP)。 结果：(1)两组患儿均完成实验,无严重麻醉、手术及体外循环并发症,无二次开胸,无术后死亡病例,40例患儿均顺利出院。(2)两组患儿的年龄、性别比、体重、病种、心功能分级、ASA分级、手术时间、体外循环时间差异无统计学意义(P0.05)。(3)两组病例的Lac在体外循环开始前麻醉诱导完成时(T0)差异无统计学意义(P0.05)。在体外循环开始后各时间点,相对于C组,P组Lac水平降低、Sp02提高、鼻咽温及中心温(肛温)复温时间缩短、尿量增加,心率无明显变化,组间差异有统计学意义(P0.05)。 结论：浅低温体外循环下心脏不停跳心内直视术后会使术前循环及代谢正常的患儿造成微循环功能障碍。长托宁对小儿浅低温体外循环下心脏不停跳心内直视术中,对微循环功能有改善作用。
[Abstract]:Objective: to observe Penehyclidine Hydrochloride (PHD), also known as Changtonin, in Penehyclidine Hydrochloride Hydrochloride. Effect of cardiopulmonary bypass on the function of microcirculation during cardiopulmonary bypass in children. Methods: 40 children with congenital heart disease underwent ASD repair or VSD repair under mild hypothermia cardiopulmonary bypass. According to the hospital number, the patients were randomly divided into two groups: group P (n = 20) and group C (n = 20). The two groups were given routine cardiac surgery anesthesia and cardiopulmonary bypass (CPB). Group P added Changtonin 0.02 mg / kg to the prefilled solution, group C was given the same amount of normal saline. Both groups were treated with mild hypothermia and beating heart surgery. The operation was performed in the state of heart beating. The operation was performed at the time of anesthesia induction, when the central temperature (anal temperature) dropped to 33 鈩，

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