| Objective To investigate the application of cardiopulmonary bypass (CPB) during esmolol on arrest cardiac valve replacement troponin I (cTn-I) the impact of changes in serum in patients with perioperative myocardial investigate whether its use can reduce myocardial injury, help patients after recovery of cardiac function.Methods in our hospital eligible for the study, aged 18 to 70 years undergoing elective cardiac arrest jumped bypass heart valve replacement surgery patients, according to figures randomly select 48 cases of patients were randomly divided into two groups,24 cases in each group, the experimental group A (esmolol), the control group for the group C. A group of patients at the start of cardiopulmonary bypass and 1minute before aortic opening were administered via the bypass pipe line to give esmolol Injection 2mg/kg, group C did not give esmolol injection, but give Equal capacity of 0.9% NaCl. Before the start of cardiopulmonary bypass (T1), Postoperative 1h (T2),24h (T3) and 48h (T4), via the venous blood serum cardiac troponin I (cTn-I) concentration values before the start of cardiopulmonary bypass; record patients with aortic blocking time, transit time, operative time, postoperative ventilator support time, CCU residence time, postoperative hospital stay; observation records of patients after aortic liter cardiac resuscitation methods, when surgery inotropic drug use type and dose of the situation. Application of SPSS 16.0 statistical analysis software, measurement data to x±s asid two sample t-test inspection,the number of multiple samples were tested using repeated measures analysis of variance, two count data were compared with the χ2 test, with a= 0.05 Detection level, p <0.05 was considered statistically different.Results The patients、age、sex、preoperative cardiac function、surgical were no significant difference between the two groups; the two groups of patients with aortic clamping time, transit time, operative time, postoperative ventilator support time, CCU stay time, postoperative hospital stay no significant differences were observed. A group of auto-resuscitation 23 cases (23/24,95.8%) than in group C 16 (16/24,67%) (χ2= 24, p= 0.042). When the surgery, dopamine injection rate in group A:4.71±1.30μg/kg/min, Group C: 4.46±1.0μg/kg/min (p> 0.05). A combination of adrenaline with the number of cases was 3/24 (12.5%) than group C 12/24 (50%) (χ2= 15.73,p=0.000); A group of surgery epinephrine injection speed of 0.005±0.013μg/kg/min, compared with group C 0.014±0.016μg/kg/min (t=2.42, p<0.05); postoperative 1h (T2),24h (T3) and 48h (T4), two groups of patients serum cTn-I values significantly higher than those of T1, T3 which reached the highest value. But after 24h (T3), A group of serum cTn-I is 10.93±4.50μg/L, serum cTn-I values lower than group C 19.07±5.06μg/L (t= 5.89, p<0.05); postoperative 48h (T4), A group of serum cTn-I is 9.06±3.87μg/L, serum cTn-I is also lower than the value of group C 15.97±4.43μg/L (t= 5.75, p<0.05).Conclusions arrest CPB in patients undergoing cardiac valve replacement and ascending before beginning the aortic opening, giving esmolol 2mg/kg dose, reduce myocardial injury, increase auto-resuscitation heart rate, postoperative recovery of cardiac function have a positive effect. |
PDF Full Text Request