七氟烷对房室缺修补术患儿心肌肌钙蛋白和肌酸激酶同工酶影响.docVIP

七氟烷对房室缺修补术患儿心肌肌钙蛋白和肌酸激酶同工酶的影响 　　【摘要】目的探讨全程吸入七氟烷对房室缺修补术患儿心肌肌钙蛋白I（cTn I）和肌酸激酶同工酶（CKMB）的影响。方法选择择期行房室缺修补术患儿30例，随机分为两组，观察组15例，对照组15例，分别于麻醉前（T0），主动脉开放后1小时（T1），主动脉开放后6小时（T2），主动脉开放后12小时（T3），主动脉开放后24小时（T4）各个时点抽取动脉血测定血清cTn I和CKMB数值。记录转机时间、主动脉阻断时间、开发主动脉至复跳时间、心脏自动复跳率、电除颤率、心律失常发生率、术后拔管时间。结果两组患儿体外循环转机时间、主动脉阻断时间、开放至复跳时间比较差异无统计学意义（P0.05），观察组术后拔管时间显著短于对照组（P0.05）。两组患儿体外循环前cTn I和CKMB均在正常范围内，cTn I在T0后逐渐升高，CKMB在T0后逐渐降低，T0后两组间各时点cTn I、CKMB比较差异有统计学意义（P001），观察组两个指标的浓度明显低于对照组。结论全程吸入七氟烷可降低房室缺修补术患儿cTn I和CKMB水平，对其心肌有保护作用。 　　【关键词】七氟烷；房室缺修补术；儿童；cTn I；CKMB 　　中图分类号：R730.53文献标识码：ADOI：10.3969/j.issn2016.02.019 　　【Abstract】ObjectiveTo evaluate the influence of total inhalation of sevoflurane on cardiac troponin I（cTn I） and creatine kinase isoenzyme （CKMB） of patients with repair of atrioventricular septal defect（ASD）.Methods30 children undergoing selective ASD were selected and randomly divided into observation group and control group with 15 cases in each.Then，cTn I and CKMB of both groups were detected before anesthesia（T0），one hour after aortic opening（T1），6 hours after aortic opening（T2），12 hours after aortic opening（T3） and 24 hours after aortic opening（T4），respectively.In addition，transit time，aortic cross-clamp time，time of opening aorta to double jump，rate of spontaneous return of heartbeat，defibrillation rate，incidence of arrhythmia and postoperative extubation time were recorded.ResultsDifference of external cycle transit time，aortic cross-clamp time and time of opening aorta to double jump of the two groups was not statistically significant（P0.05）.Postoperative extubation time of the observation group was significantly shorter than that of the control group（P0.05）.cTn I and CKMB of both groups were within normal range，cTn I gradually increased after T0，while CKMB gradually decreased after T0.After T0，there were significant differences in cTn I and CKMB between the two groups at each time point（P0.01），concentrations of the two indexes of the observation group were significan