改良Del Nido与国产HTK停搏液在成人心脏瓣膜置换术中的应用效果

Application of Modified Del Nido and Domestic HTK Cardioplegics in Adult Heart Valve Replacement Surgery

目的:分析改良Del Nido与国产HTK停搏液在成人心脏瓣膜置换术中的应用效果。方法:回顾性分析2022年1月—2023年7月钦州市第一人民医院收治的60例心脏瓣膜置换术患者资料。根据停搏液使用情况将其分为DN组(30例)和HTK组(30例)。HTK组使用国产HTK停搏液,DN组使用改良Del Nido停搏液。比较两组围手术期指标,术后24 h、48 h相关指标及肾功能。结果:DN组灌注次数多于HTK组,术后机械通气时间长于HTK组,主动脉阻断时间短于HTK组,自动复跳率高于HTK组,差异有统计意义(P<0.05)。两组术后24 h、48 h心肌肌钙蛋白(cTnI)、肌酸激酶同工酶(CK-MB)水平比较,差异无统计意义(P>0.05)。两组术后24 h、48 h血尿素氮(BUN)、血肌酐(Scr)水平比较,差异无统计意义(P>0.05)。结论:与国产HTK停搏液对比,改良Del Nido停搏液应用于成人心脏瓣膜置换术中能缩短主动脉阻断时间,提高自动复跳率,灌注次数较多,术后机械通气时间较长,但两者均具有良好的心肌保护作用。

Objective:To analyze effect of modified Del Nido and domestic HTK cardioplegia in adult heart valve replacement surgery.Method:The data of sixty patients with heart valve replacement surgery admitted to the Qinzhou First People's Hospital from January 2022 to July 2023 were retrospectively analyzed.The patients were divided into DN group(30 cases)and HTK group(30 cases)according to the use condition of cardioplegia.HTK group was treated with domestic HTK cardioplegia and DN group was treated with modified Del Nido cardioplegia.Perioperative indexes,postoperative 24 h and 48 h related indexes and renal function were compared between the two groups.Result:The perfusion times of DN group were higher than those in HTK group,the postoperative mechanical ventilation time was longer than that in HTK group,the aortic occlusion time was shorter than that in HTK group,and the automatic relapse rate was higher than that in HTK group,the differences were statistically significant(P<0.05).There was no significant difference in myocardial troponin(cTnI)and creatine kinase isoenzyme(CK-MB)levels between the two groups at 24 h and 48 h after surgery(P>0.05).There was no significant difference in blood urea nitrogen(BUN)and creatinine(Scr)levels between the two groups at 24 h and 48 h after surgery(P>0.05).Conclusion:Compared with domestic HTK cardioplegia,the modified Del Nido cardioplegia used in adult heart valve replacement surgery can shorten the time of aortic occlusion,increase the automatic relapse rate,the number of perfusion is many and postoperative mechanical ventilation time is long,but both of them have good myocardial protection function.