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find Author "骆璇" 2 results
  • Protecting Effect of Remote Ischemic Preconditioning on Myocardium in Cardiac Valve Surgery

    ObjectiveTo investigate whether there is a protecting effect of remote ischemic preconditioning (RIPC) on patients underwent cardiac valvular surgery. MethodWe retrospectively analyzed the clinical data of 72 adult patients underwent cardiac valvular surgery in our hospital from Febuary 2014 through April 2015 year. There were 26 males and 46 females with an age ranging from 23-68 years. We devided 72 patients into a RIPC group and a control group. There were 14 males and 28 females with a mean age of 48.87±12.28 years in the RIPC group. After the induction of anesthesia, the RIPC group was induced by three cycles of right upper limb ischemia and reperfusion using a blood pressure cuff. The blood pressure cuff was inflated to 200 mm Hg and we held it on for 5 minutes, deflated to 0 mm Hg and maintained for 5 minutes, which was defined as one cycle. There were 10 males and 20 females with a mean age of 47.70±8.07 years in the control group. We placed a standard blood pressure gasbag on the right upper limb for 30 minutes without inflation in the control group. We recorded the clinical data including cardiopulmonary bypass (CPB) time, the cross-clamping time of ascending aorta, preoperative ejection fraction (EF), EF after discharging, postoperative complica-tion and mortality. Blood were sampled preoperatively (T0), 30 minutes after RIPC (T1), 30 minutes aftr the cardiopul-monary bypass finished (T2), 24 hours (T3), 48 hours (T4) and 72 hours (T5) after surgery to detect the concentration of troponin T (cTnT) and creatine kinase-MB (CK-MB). We counted the person-time used dopamine and norepinephrine. ResultThere was no death in both groups. The mechanical ventilation time, the time of ICU stay, the time of hospital stay, the number of person used vasoactive agent, and the EF when discharging showed no statistical difference between the two groups. Levels of cTNT in the RIPC group were statistically lower than those in the control group at T2 and T3 (P=0.001, P=0.001). Levels of CK-MB in the RIPC group were statistically lower than those in the control group at T2, T3, and T4 (P=0.011, P=0.010, P=0.033). ConclusionRIPC may have protective effect on myocardium for patients underwent cardiac valvular surgery.

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  • 体外循环心内直视手术中鱼精蛋白致严重循环抑制的治疗

    目的 总结体外循环心内直视手术中鱼精蛋白所致严重循环抑制的救治经验。 方法 回顾性分析 2016 年 6 月至 2017 年 7 月我中心体外循环心内直视手术中给予鱼精蛋白中和肝素后出现严重循环抑制 9 例患者的临床资料,其中男 7 例,女 2 例,年龄 62.3(36~78)岁。7 例为左心室肥厚者。分析其临床特点及处理方法。 结果 1 例因反复给予鱼精蛋白而循环衰竭死亡,1 例因非鱼精蛋白原因死亡,余 7 例经肝素化转机和/或垂体后叶素等血管活性药抢救后好转。 结论 鱼精蛋白毒性反应所导致的严重循环抑制为突发事件且往往危及生命,果断肝素化转机和垂体后叶素的及时应用是成功挽救患者生命的重要环节。

    Release date:2018-06-26 05:41 Export PDF Favorites Scan
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