丹参及654-2对体外循环胃肠缺血再灌注损伤保护作用.docVIP

丹参及654-2对体外循环胃肠缺血再灌注损伤保护作用 　 作者：田宝文，张强华，周钢，高荣升 【关键词】 缺血再灌注损伤 摘要：目的 探讨丹参和654-2注射液对体外循环（CPB）心内直视手术后胃肠缺血再灌注损伤的保护作用。方法 60例CPB心内直视手术病人随机分为治疗组（n=30）和对照组（n=30）。治疗组于麻醉后、体外循环中静脉滴注丹参注射液40ml和654-2注射液0.5mg/kg。对照组按常规方法治疗。两组分别于术前、术后2h、12h、24h、48h和72h从胃管中抽取胃液检测pH值，红细胞计数和上皮细胞计数。观察CPB术后病人的消化道症状。结果 两组病人CPB术后pH值均较术前显著下降，红细胞计数和上皮细胞计数明显升高。治疗组pH值较对照组显著增高，红细胞计数和上皮细胞计数明显降低。治疗组病人CPB术后的消化道症状发生率较对照组低。结论 CPB术后的胃粘膜出现缺血再灌注损伤。丹参和654-2注射液对CPB术后胃肠缺血再灌注损伤有明显的保护作用。 　　关键词：体外循环；缺血再灌注损伤；胃肠保护；丹参注射液；654-2注射液 　　Protective Effect of Composite Salviae and Anisodamine Injection on Gastrointestinal Ischemia-Re Perfusion Damage in Patients Undergoing Cardiopulmonary Bypass 　　Abstract: OBJECTIVE To study the protective effect of composite salviae and anisodamine injection (654-2) on gastrointestional ischemia-reperfusion damage in patients undergoing heart surgery with cardiopulmonary bypass. METHODS 60 patients scheduled for cardiac surgery with CPB were randomly divided into two groups,expermental group(n=30) and control group(n=30). The experimental group patients received 40 ml composite salviae injection and anisodamine injection 0.5mg/kg after anethesia, during CPB. The control group received conventional perioperative therapy. The following measurement were made on all patients：pH value,RBC numbers and epithelial cell numbers in gastric juice before CPB, and 2h,12h, 24h, 48h and 72h after CPB. The patients were observed for alimentary symptoms.RESULTS PH value after CPB decreased notably compared with the values before CPB,RBC numbers and epithelial cell numbers after CPB increased notably compared with those before CPB. PH values of experimental group were higher than control group. The morbidity of alimentary symptoms in the experimental group after CPB was lower than the control group.CONCLUSION Patients surffer gastrointestinal ischemia reperfusion damage after CPB. The composite salviae and anisodamine injections provide protective effect on gastrointestinal ischemia reperfusion damage in patients u