缺血后处理对法乐四联症患者的心肺保护作用

Impacts of ischemic postconditioning on cardiopulmonary protection

目的观察缺血后处理对法乐四联症患者的心肺保护作用。方法将114例法乐四联症根治术患者随机分为对照组和实验组，对照组行常规手术，实验组同时给与缺血后处理。术后比较两组患者的ICU治疗时间、血流动力学、呼吸功能以及乳酸代谢。结果与对照组比较，术后实验组ICU治疗时间明显缩短[（51±31）h比（40±24）h，P〈0．05]，正性肌力药物剂量明显减少（11．8±8．0）与（5．6±5．0），血流动力学和呼吸功能恢复更好，乳酸蓄积更少（35．1±14．0）与（53．0±36．1）。结论缺血后处理对法乐四联症根治术患者有心肺保护作用。

Objective To investigate the effect of ischemic postconditioning on myocardial and puhnonary protection in patients undergoing cardiac surgery for tetralogy of Fallot. Methods One hundred and forteen patients with tetralogy of Fallot were randomly assigned to control group （ n = 60） or ischemic postconditioning group （ n = 54）. The postconditioning was performed by intermittent aortic clamping after reperfusion. The length of ICU stay, hemodynamics, respiratory function, release of lactate were assayed. Results As compared with control group,the ICU stay was significantly shortened [ （40 ±24） h vs （51± 31 ） h, P 〈 0. 05 ] , the inotrope score was significantly reduced （ 5.6 ± 5.0 vs 11.8 ± 8.0） , the parameters of hemodynamics and respiratory function were improved significantly, and lactate release reduced （35.1 ± 14.0 vs 53.0 ± 36.1 ） in postconditioning group. Conclusion Ischemic postconditioning may provide salutary effects with respect to myocardial and pulmonary protection in patients undergoing repair for tetralogy of Fallot.