在冠状动脉旁路手术期间,内腔右心冷却. 一个潜在的随机试验
E H Cheung1, J M Arcidi, E R Jackson
1Carlyle Fraser Heart Center, Crawford Long Hospital, Emory University, Atlanta, Georgia 30365.
Circulation
|November 1, 1988
概括
增强右心冷却 (RHC) 在开放心脏手术期间有效降低心脏温度,但没有减少并发症. 这项研究发现,RHC与标准冷却相比,在预防冠状动脉旁路手术后的不良结果方面没有显著的益处.
科学领域:
- 心血管外科心血管外科
- 通过心肺绕道术 (Cardiopulmonary Bypass) 进行心肺绕道.
- 肌心保护 肌心保护
背景情况:
- 提升右心冷却 (RHC) 建议用于预防心脏手术后的右心室衰竭和心律失常.
- RHC涉及双管管道,肺动脉通风和腔内冷却.
研究的目的:
- 评估RHC在冠状动脉绕道手术后预防右心室衰竭和脑上心室动脉节律失常的疗效.
- 为了比较RHC与标准的单个心房管道 (SC) 保护.
主要方法:
- 预期随机试验78名接受冠状动脉旁路手术的患者.
- 患者被随机分配到RHC (n=38) 或SC (n=40).
- 关键参数包括心脏温度,绕道时间,心脏酶水平和临床结果被监测.
主要成果:
- 与SC相比,RHC显著降低了右心房和右心室温度.
- 群体之间没有显著的区别在右或左心脏功能后绕道.
- 在RHC患者手术后经历了更长的绕道时间和更高的肌酸激酶-MB水平.
- 在RHC和SC组之间,死亡率,发病率和上心脉动节律失常是相似的.
结论:
- 增强右心冷却可以降低心脏温度,但在预防冠状动脉绕道手术后的不良结果方面,与标准冷却相比,它没有显著的临床优势.
- 与RHC相关的 बाईपास时间增加和心肌酶释放值得考虑.
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