参附注射液在二尖瓣及主动脉瓣联合置换术后治疗疗效观察

Effect of Shenfu Injection on postoperation of mitral and aortic valve combined replacement

目的:观察参附注射液在二尖瓣及主动脉瓣联合置换术后的治疗效果。方法:择期二尖瓣联合主动脉瓣换瓣病人46例,随机分为观察组(24例)与对照组(22例),观察组患者术后当天及术后1-5d,每天使用参附注射液50mL加入5%葡萄糖注射液250mL中静滴,其他治疗与对照组患者相同,监测术前及术后左室收缩末期内径(LVSD)、左室舒张末期内径(LVDD)、左室射血分数(LVEF),心肌损伤生化指标,多巴胺用量及呼吸机辅助呼吸时间。结果:观察组左室收缩末期内径降低与左室射血分数升高程度高于对照组(P<0.05),肌酸激酶同工酶(CK-MB)、肌钙蛋白I(cTnI)、肌红蛋白(MYO)升高程度明显低于对照组(P<0.05),术后多巴胺用量及呼吸机辅助时间明显少于对照组(P<0.05)。结论:参附注射液应用于二尖瓣及主动脉瓣联合置换术后能够明显改善术后心脏功能,疗效优于单纯使用西药治疗。

Objective： To investigate the effect of Shenfu injection on postoperation of mitral and aortic valve combined replacement surgery.Methods：46 cases, elective patients with mitral and aortic valve combined replacement in September 2008 to December 2009,were randomly assigned into two groups, the observation group 24 patients with the control group 22 patients. The Shenfu Injection, 50ml with 5% glucose injection 250ml,was used on postoperative day and 1-5day after that in the observation group. Other treatments were in the same with the control group patients. Monitoring pre and postoperative left ventricular end systolic diameter （LVSD）,left ventricular end diastolic diameter （LVDD）,left ventricular ejection fraction （LVEF）,biochemicalmarkers of myocardial injury, dopamine dosage and the time of ventilator-assisted breathing. Results： The levels of reducing of left ventricular end systolic diameter and increasing of left ventricular ejection fraction in the observation group were higher than those in the control group（P〈0.05）.The contents of Creatine kinase isoenzyme （CK-MB）, troponin I cTn I）, myoglobin （MYO） in the observation group increased less than those in the control group（P〈0.05）.Dopamine dosage and postoperative mechanical ventilation time significantly lower than the control group（P〈0.05）.Conclusions： The Shenfu Injection used after mitral and aortic valve combined replacement can significantly improve the postoperative cardiac function. Effect is better than the use of western medicine alone.