Application Of Freeze-dried Recombinant Human Brain Natriuretic Peptide In Perioperative Period Of Cardiac Surgery

Objective:The patients after cardiac surgery were randomly divided into two groups,one group was treated with symptomatic therapy,the other group was treated with freezing-dried recombinant human brain natriuretic pepti(rh BNP),and the rest of the treatment was basically the same.The postoperative changes of cardiac and renal function in the two groups were analyzed,and the effect of rh BNP on the improvement of postoperative organ function was evaluated,so as to provide medication basis for postoperative rehabilitation of cardiac surgery patients in the future.Methods:A total of 80 patients who received heart valve replacement or coronary artery bypass grafting in Chengde Central Hospital from January 2015 to October 2022 were retrospectively selected,all of which were assisted by CPB.All patients returning to the ICU after surgery were randomly divided into two groups of equal numbers.Control group was given symptomatic treatment of vascular drugs,intensive care nursing,water fasting,intravenous fluid,etc.;The experimental group was treated with rh BNP(specification: 0.5mg/μg/kg),the first dose was 1.5μg/kg,and then was injected intravenously at the rate of0.008ug/kg/min for 72 hours.Blood pressure,urine volume,CVP,central venous pressure and other changes of the patients were observed,and the medication method of rh BNP was adjusted according to the clinical indicators of the patients.1.Blood samples of patients were collected for c Tn I,NT-Pro BNP,CK-MB,etc.,and the changes of central venous pressure were recorded and echocardiography was improved before and 24 h,3 and 7 days after surgery.Left ventricular ejection fraction(LVEF),end-systolic internal diameter(LVESD),end-diastolic internal diameter(LVEDD)and other indicators were recorded to evaluate the recovery of cardiac function.2.Venous blood extraction monitoring patients’ blood creatinine(Scr),urea nitrogen(BUN)changes,while recording patients’ urine volume,analysis of postoperative renal function changes.3.The duration of ventilator use,ICU monitoring and the time of hospital stay,and the impact of rh BNP on the family economy of the patients was evaluated.Results:1.After the data analysis of the patients involved in the study,it was found that there were no significant differences in age,disease course,gender,complications(such as diabetes,dyslipidemia,hypertension),NYHA grade of cardiac function(Ⅱ,Ⅲ,Ⅳ),drinking history,smoking history and other data(P > 0.05).2.Preoperative c Tn I,CK-MB,Scr,BUN,NT-Pro BNP,LVEF,LVESD,LVEDD,CVP,urine volume of two groups of patients,through analysis,P >0.05,the data difference is comparable.3.All patients 24 hours after the operation of Scr,BUN,CK-MB,c Tn I,NT-Pro BNP,urine volume,were higher than preoperative,there was no significant difference between the two groups of patients(P > 0.05).4.The indexes of the two groups 3 days after surgery were analyzed,and the mean value of LVEF in the experimental group was higher than that in the control group(P > 0.05);At 3 days after surgery,LVEDD and LVESD of all patients were lower than those before surgery,and the experimental group was lower than the control group(P > 0.05).NT-Pro BNP,c Tn I,BUN decreased 24 hours after surgery,the experimental group was smaller than the control group(P > 0.05);The CK-MB and Scr of the two groups were decreased at 3 days after surgery compared with 24 hours after surgery,and the experimental group was less than the control group(P < 0.05).The urine volume of the experimental group was higher than that of the control group 3 days after operation(P < 0.05),and the difference was significant after analysis.5.The urine volume and LVEF of all patients at 7 days after surgery were higher than those at 3 days after surgery,and the experimental group was higher than the control group(P < 0.05);The CVP of the experimental group was lower than that of the control group 7 days after surgery(P < 0.05).At the same time,the LVEDD,NT-Pro BNP,LVESD of the two groups 7 days after surgery decreased than 3 days after surgery,the experimental group was lower than the control group(P > 0.05);7 days after the operation of two groups of patients with c Tn I,CK-MB,Scr,BUN were compared with 3 days after the operation decreased,and the experimental group was smaller than the control group of patients(P < 0.05),the difference was significant after analysis.6.LVEF of all patients at 30 days after surgery was higher than that at 7days after surgery,and the experimental group was higher than the control group(P < 0.05);The ratio of LVEDD and LVESD decreased 7 days after operation,and the experimental group was lower than the control group(P <0.05),the data was significant after analysis.7.Patients in the control group spent more time in the intensive care unit,spent more time on the ventilator and spent more time in hospital than those in the experimental group,and the differences between the two groups were significant(P < 0.05).Conclusion:1.For patients undergoing cardiac surgery,the application of rh BNP after surgery can reduce the myocardial damage of patients,reduce the patient’s CK-MB,c Tn I,LVESD,LVEDD,NT-Pro BNP,CVP,improve the patient’s LVEF,can make the patient’s heart function has been significantly improved.2.For patients undergoing cardiac surgery,the application of rh BNP after surgery can reduce the patient’s Scr,BUN,while improving the patient’s urine volume,can effectively improve the patient’s renal function damage.3.For patients undergoing cardiac surgery,the application of rh BNP can reduce the postoperative ventilator use time,ICU care time and total hospital stay,indicating that rh BNP can accelerate the postoperative recovery time of patients,promote the recovery of patients,and reduce the economic pressure of patients.