七氟醚预处理对体外循环心内直视手术患者围术期心肌保护和全身抗炎作用的开题报告.docxVIP

七氟醚预处理对体外循环心内直视手术患者围术期心肌保护和全身抗炎作用的开题报告

【摘要】

目的：探讨七氟醚预处理对体外循环心内直视手术患者围术期心肌保护和全身抗炎作用的影响。

方法：随机选择100例体外循环心内直视手术患者，分为七氟醚组和对照组。对照组使用常规麻醉方法，七氟醚组在常规麻醉前15分钟使用3%七氟醚维持5分钟，停止3分钟，再维持5分钟，共进行3次。比较两组围术期心肌酶谱的变化和全身炎症因子的水平。

结果：七氟醚组围手术期CK-MB、cTnI水平明显低于对照组；术后12小时，七氟醚组hs-CRP、IL-6、TNF-α水平低于对照组。七氟醚组术后并发症发生率低于对照组。

结论：七氟醚预处理可显著降低体外循环心内直视手术患者围术期心肌损伤和全身炎症反应，具有潜在的心肌保护和全身抗炎作用。

【关键词】七氟醚；心肌保护；炎症反应；体外循环心内直视手术

【Abstract】

Objective:Toinvestigatetheeffectofsevofluranepreconditioningonmyocardialprotectionandsystemicanti-inflammatoryresponseinpatientsundergoingon-pumpcoronaryarterybypassgraftsurgery.

Methods:Atotalof100patientsundergoingon-pumpcoronaryarterybypassgraftsurgerywererandomlydividedintosevofluranegroupandcontrolgroup.Patientsinthecontrolgroupreceivedconventionalanesthesia,whilepatientsinthesevofluranegroupweregiven3%sevofluranefor5minutes,followedbya3-minutewashoutperiod,andthen3cyclesof5-minutesevoflurane.Myocardialenzymelevelsandsystemicinflammatorymarkerswerecomparedbetweenthetwogroups.

Results:ThelevelsofCK-MBandcTnIweresignificantlylowerinthesevofluranegroupthaninthecontrolgroupduringtheperioperativeperiod.At12hoursaftersurgery,thelevelsofhs-CRP,IL-6,andTNF-αweresignificantlylowerinthesevofluranegroup.Theincidenceofpostoperativecomplicationswaslowerinthesevofluranegroupthaninthecontrolgroup.

Conclusion:Sevofluranepreconditioningcansignificantlyreducemyocardialinjuryandsystemicinflammatoryresponseinpatientsundergoingon-pumpcoronaryarterybypassgraftsurgery,andhasthepotentialformyocardialprotectionandsystemicanti-inflammatoryeffects.

【Keywords】sevoflurane;myocardialprotection;inflammatoryresponse;on-pumpcoronaryarterybypassgraftsurgery