心脏不停跳二尖瓣置换术心肌保护的系统评价

Evaluation on the myocardial protection of mitral valve replacement with beating heart

目的用Meta分析的方法对国内已发表的有关心脏不停跳二尖瓣置换术的心肌保护进行系统评价。方法收集国内已公开发表的有关心脏不停跳二尖瓣置换术临床随机双盲对照实验,以检测血清肌钙蛋白I(cTn-I)为标准,对符合要求的研究进行Meta分析。结果共纳入3项研究符合标准,所有研究均未描述具体的随机方法,分配隐蔽和盲法。以cTn-I为检测标准,对麻醉诱导后、升主动脉开放后(或心内主要操作完成)2h及术后12、24、48h等5个时间点进行比较,发现不停跳组cTn-I在术后2、12、24、48h等4个时间点均比对照组低。结论浅低温心脏不停跳对二尖瓣置换术具有良好的心肌保护效果。

Objective To carry out a meta-analysis to evaluate the effect of mitral valve replacement （MVR） with beating heart on myocardial protection, Methods The analysis of the levels of cardiac troponin （cTn-Ⅰ） used data from published radomlzed double-blind control trials acurd with cTn-Ⅰ requirement, Results A total of three trials was eligible for the inclusion criteria, All included studies were inadequate in reporting randomization,concealment of allocation, Serum levels of cTn-Ⅰ was measured after anesthesia and at 2,12,24,48 hours after aortic declamping or intra-cardiac manipulation fin/shed, cTn-Ⅰ levels in beating heart group were lower than those in control group at 2,12,24,48 hours after operation, Conclusion Beating heart with mild hypothermia has good myocardial protection effects on MYR.