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ID:33378839
大小:2.67 MB
页数:40页
时间:2019-02-25
《灯盏花素对体外循环心内直视手术患儿肺损伤的保护作用》由会员上传分享,免费在线阅读,更多相关内容在学术论文-天天文库。
1、温州医学院硕士学位论文灯盏花素对体外循环心内直视手术患儿肺损伤的保护作用姓名:陈军申请学位级别:硕士专业:麻醉学指导教师:上官王宁2012-05-24画温州医学院硕士学位论文灯盏花素对体外循环心内直视手术患儿肺损伤的保护作用中文摘要目的拟通过给予心内直视手术患儿体外循环(CPB)前静脉泵注灯盏花素,观察CPB术后肺损伤情况并评价灯盏花素是否具有肺功能保护作用以及可能的机制。方法择期行房、室问隔缺损修补术的学龄前患儿(≤6岁)45例,随机分成对照组(C组,空白生理盐水)、低剂量灯盏花素组(Bre0.5组,0.5mg/kg灯盏花素)和高剂量灯盏花素组(Brel.0组,lmg
2、/kg灯盏花素)3组,每组各15例。于诱导完成后开始微泵静脉输注15ml空白生理盐水或灯盏花注射液,30min内输注完毕。分别于切皮前(To)、主动脉阻断开放后30min(T。)、lh(T。)、术后3h(T3)及术后6h(T。)测定中性粒细胞弹性蛋白酶(NE)、前降钙素(PCT)浓度以及各时间点动脉血气。同时记录手术时间、CPB时间、主动脉阻断时间,上下腔静脉阻断时间。所有患儿术中使用的咪达唑仑、异丙酚和芬太尼的给药总量也一并记录。结果3组患儿性别比、年龄、体重、上下腔静脉阻断时间、主动脉阻断时间、CPB时间、手术时问和术中咪达唑仑、异丙酚和芬太尼的给药总量,氧合指数和
3、肺泡动脉血氧分压差比较差异均无统计学意义。与基础值(T0点)相比,3组患儿PCT于主动脉阻断开放后T,、T:、T。及T4均明显升高(P<0.01),峰值出现于主动脉阻断开放后30min(T,点)。与C组相比,Bre0.5、Brel.0组PCT在T。、T2、T。、T4时问点较低(P<0.01),Bre0.5、Brel.0两组间无差异。与基础值(T。点)相比,C组患儿NE在T,、T。、T。、T4均明显增高(Y<0.01)且于T。达高峰;BreO.5、Brel.0组在T。明显增高(P4、P5、Toexploretheeffectsofbreviscapineonpulmonaryinflammatoryresponseandlungfunctioninpediatricpatientsundergoingopenheartsurgery.Methods:45children(ASAIIorIII,aged2—72month)wererandomlyassignedtocontrolgroup(saline,GroupC),lowdosebreviscapinegroup(O.5mg/kg,GroupBre0.5),andhighdosebreviscapin6、egroup(1.0mg&g,GroupBre1.0)threegroups,15caseseachgroup.15mlofsalineorbreviscapineinjectionwasadministeredwithin30minutesaftertheinductionbypump.Concentrationsofprocalcitonin(PCT)andneutrophilelastase(NE)weremeasuredattimepointsofbaseline(beforeskinincision,To),themomentofaorticunclampin7、g(T0,30min,lhafteraorticunclamping(T2,T3)and3h,6hpost—operation(T3,T4).Results:Therewerenotdifferentfortheoxygenationindex(OI)andD(A-a)02amongthreegroupsatTo,T3,T4.Comparedwiththebaseline(To),theplasmaconcentrationsofPCTandNEincreasedatTl一4(P
4、P5、Toexploretheeffectsofbreviscapineonpulmonaryinflammatoryresponseandlungfunctioninpediatricpatientsundergoingopenheartsurgery.Methods:45children(ASAIIorIII,aged2—72month)wererandomlyassignedtocontrolgroup(saline,GroupC),lowdosebreviscapinegroup(O.5mg/kg,GroupBre0.5),andhighdosebreviscapin6、egroup(1.0mg&g,GroupBre1.0)threegroups,15caseseachgroup.15mlofsalineorbreviscapineinjectionwasadministeredwithin30minutesaftertheinductionbypump.Concentrationsofprocalcitonin(PCT)andneutrophilelastase(NE)weremeasuredattimepointsofbaseline(beforeskinincision,To),themomentofaorticunclampin7、g(T0,30min,lhafteraorticunclamping(T2,T3)and3h,6hpost—operation(T3,T4).Results:Therewerenotdifferentfortheoxygenationindex(OI)andD(A-a)02amongthreegroupsatTo,T3,T4.Comparedwiththebaseline(To),theplasmaconcentrationsofPCTandNEincreasedatTl一4(P
5、Toexploretheeffectsofbreviscapineonpulmonaryinflammatoryresponseandlungfunctioninpediatricpatientsundergoingopenheartsurgery.Methods:45children(ASAIIorIII,aged2—72month)wererandomlyassignedtocontrolgroup(saline,GroupC),lowdosebreviscapinegroup(O.5mg/kg,GroupBre0.5),andhighdosebreviscapin
6、egroup(1.0mg&g,GroupBre1.0)threegroups,15caseseachgroup.15mlofsalineorbreviscapineinjectionwasadministeredwithin30minutesaftertheinductionbypump.Concentrationsofprocalcitonin(PCT)andneutrophilelastase(NE)weremeasuredattimepointsofbaseline(beforeskinincision,To),themomentofaorticunclampin
7、g(T0,30min,lhafteraorticunclamping(T2,T3)and3h,6hpost—operation(T3,T4).Results:Therewerenotdifferentfortheoxygenationindex(OI)andD(A-a)02amongthreegroupsatTo,T3,T4.Comparedwiththebaseline(To),theplasmaconcentrationsofPCTandNEincreasedatTl一4(P
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