体外循环心脏术后高淀粉酶血症对预后的影响-内科急危重症杂志.DOCVIP

体外循环心脏术后高淀粉酶血症对预后的影响 武汉亚洲心脏病医院ICU 李颖 刘彬 黄园琴 　　 摘 要目的：分析体外循环心脏术后患者发生高淀粉酶血症对预后的影响。方法：选择2012年8月至2013年1月我院在全麻体外循环下行心脏手术的成人患者100例，排除术前有胰腺病变、胆石症病史患者。于入ICU即刻、术后24h、48h、72h抽取外周静脉血2m1注入不抗凝试管，分离血清后用Somog-yi法测定血淀粉酶。同时监测白细胞计数(WBC)、C-反应蛋白(CRP)、降钙素原（PCT））ith general anaesthesia and cardiopulmonary bypass during the study period of Augest 1st,2012 to January 31th,2013 at Wuhan Asia Heart Hospital were enrolled in the study. Patients with acute pancreatitis, a history of benign and malignant pancreatic diseases were excluded in this study.Two milliliter peripheral blood of the patients were collected into tube without heparin at the moment of entering ICU、24 hours 、48 hours、72hours after operation.The serum amylase measured by Somog-yi method.WBC、CRP、PCT were measured at the same time and the rectilinear correlation with them and serum amylase were studied.The patients were divided into three groups based on serum amylase level．The morbiditis of renal insufficiency、hepatic insufficiency、gastrointestinal function failure、infection in hospital、multiple organdys function syndrome，the time of mechanical ventilation，time of staying in ICU，mortality in hospital were compared.The dabetes mellitus、intemperance、hypotension、low cardiac output were recorded.Result WBC、PCT were related to postoperative hyperamylasemia,but PCT were not related to postoperative hyperamylasemia. The mortality in hospital and the morbiditis of renal insufficiency、infection in hospital、multiple organdys function syndrome in hyperamylasemia group were higher than other groups（P0.05）.The time of staying in ICU in hyperamylasemia group was longer than other groups（P0.05）. The morbiditis of hypotension、low cardiac output in hyperamylasemia group were higher than other groups.Conclusions The inflammation reaction was related with postoperative hyperamylasemia after cardiac operation with cardiopulmonary bypass.The postoperative hyperamylasemia revealed worse prognosis.Hypotension and low cardiac output may be th