磷酸肌酸停搏液对法洛四联症患儿的心肌保护作用.docVIP

磷酸肌酸停搏液对法洛四联症患儿的心肌保护作用 作者：曹倩,邢泉生,李自普 作者单位：青岛市儿童医院儿童心脏中心，山东 青岛 266011 【摘要】 目的 探讨磷酸肌酸钠（CP）停搏液对法洛四联症（TOF）患儿术后心功能恢复的影响及其临床应用价值。方法 60例择期行TOF根治术患儿，随机分为两组：①对照组，常规使用改良St.ThomasII号心脏停搏液；②外源性磷酸肌酸钠组（CP组），在心脏停搏液中加入注射用磷酸肌酸钠。于转机前及术后24 h分别采血测定心肌酶谱，记录血管活性药物使用情况。结果 CP组的心脏自动复跳率明显高于对照组，机械通气与ICU停留时间也较对照组明显缩短，心肌酶谱各指标均显著低于对照组。离室前多巴胺辅助剂量大于4 Μg/(kg·min)者对照组和CP组分别为14例和7例，两组需肾上腺素支持者（11例和5例）同样有显著区别（P 0.05）。CP组术后24h和48 h正性肌力药物（多巴胺、肾上腺素和米力农）应用量均较对照组小，其他药物使用量未见明显差异。结论 磷酸肌酸钠心脏停搏液有利于TOF患儿术后心功能恢复。 【关键词】 法洛四联症；体外循环；磷酸肌酸钠；心脏停搏液 　　Myocardial Protective Effect of Cardioplegic Solution Enriched with Creatine Phosphate Sodium in Children with Tetralogy of Fallot Undergoing Radical Operation 　　CAO Qian, XING Quan-sheng, LI Zi-pu,WANG Kui-liang,CHAI Jie 　　(Childrens Heart Center, Qingdao Childrens Hospital, Shandong Qingdao 266011;Affiliated Hospital of Medical College, Qingdao University, Shandong Qingdao 266003，China) 　　Abstract: OBJECTIVE To investigate the effect of creatine phosphate sodium on myocardium protecting in children with tetralogy of fallot after radical operation and its clinical value. METHODS 60 children(weight: 10.5±2.1kg, age:from 8 months to 3 years) suffering from tetralogy of fallot undergoing selective radical operation were randomly divided into two groups: group A using modified St.ThomasII solution, and group B using the same solution but added with 10 mmol/L exogenous creatine phosphate sodium. Blood samples were collected before the extracorporeal circulation and 24 hours after the operation. Analysis of myocardial enzymes was made for detection of myocardial damage and the administration of vasoactive drugs was also noted down. RESULTS The automatic recovery rate of heart beat in group B was much higher than that in group A, and the duration of mechanical ventilation and ICU settling was also apparently shorter in group B than in group A. The data collected from the analysis of myocardial enzymes demonstrated that myocardial damage in