康斯特保护液在冠状动脉旁路移植术中的临床应用

Clinical application of custodiol solution in coronary artery bypass grafting

目的探讨康斯特保护液(HTK液)在冠状动脉旁路移植术中的体外循环管理策略。方法回顾本院2012年9月至2014年9月296例冠状动脉旁路移植手术,常规建立体外循环,主动脉阻断后灌注HTK液,停搏液经腔房管完全回流入体外循环系统,观察转流过程HTK液对患者的各项重要的生命指标的影响。结果大量冷晶体液进入体外循环系统,阻断后的血钾、血钠、红细胞比容及胶体渗透压均较灌注前有显著变化(P<0.05)。结论 HTK液对内环境的影响大,需要灌注师熟悉HTK液的影响特点,及时将各项指标调整到正常范围,将HTK液对内环境的不良影响降至最低。

Objective To discuss the management of custodiol（ HTK） solution in coronary artery bypass grafting. Methods From Sept. 2012 to Sept. 2014,a total of 296 patients underwent coronary artery bypass grafting. Extracorporeal circulation was established regularly. HTK solution was perfused after the aorta block and went to extracorporeal circulation through the circuit. The changes of vital indexes were observed during perfusion. Results Cold crystalloid solution that entered extracorporeal circulation resulted in significant changes,including： potassium,colloid osmotic pressure,serum sodium,hematocrit（ P〈0. 05）. Conclusion As HTK solution has great influence on internal environment,perfusionistshaveto be familiar with features of HTK solution and adjust the indicators to the normal range to keep the impact of HTK solutionto the minimum.