中国地方病学杂志
中國地方病學雜誌
중국지방병학잡지
CHINESE JOURNAL OF ENDEMIOLOGY
2011年
6期
691-693
,共3页
王海永%姜亦瑶%张文斌%宋剑非%刘帅洲
王海永%薑亦瑤%張文斌%宋劍非%劉帥洲
왕해영%강역요%장문빈%송검비%류수주
葡萄糖-6-磷酸酶%缺乏症%体外循环
葡萄糖-6-燐痠酶%缺乏癥%體外循環
포도당-6-린산매%결핍증%체외순배
Glucose-6-phosphatase%Deficiency diseases%Extracorporeal circulation
目的 观察葡萄糖-6-磷酸脱氢酶(G6PD)缺乏症患者心脏体外循环围手术期治疗方法.方法 以2005年1月至2010年12月间在广西桂林医学院附属医院中进行心脏手术的10例G6PD缺乏症确诊患者作为病例组观察对象.同期选取性别、年龄、体质量、所患心脏手术疾病相匹配的20例非G6PD缺乏症患者作为对照组观察对象.病例组患者围手术期治疗措施集中于避免药物引起的急性溶血反应,减少手术应激,采用浅低温体外循环,加强血液保护等.观察指标包括患者围手术期呼吸机辅助时间、尿量、胸管引流量、输红细胞悬液量、输血浆量、术后第2天血红蛋白和血总胆红素水平,重症监护病房(ICU)停留时间等.结果 病例组呼吸机辅助时间[(8.6±5.7)h]、尿量[(1950±490)ml]、胸管引流量[(260±l20)ml]、输红细胞悬液量[(1.8±1.2)U]、输血浆量[(80±50)ml]、术后第2天血红蛋白[(99±12) g/L]和总胆红素水平[(27±11)μmol/L]与对照组比较[(9.3±4.5)h、(2100±670)ml、(253±146)ml、(1.3±1.0)U、(120±50)ml、(96±25)g/L、(24±8)μmol/L],差异均无统计学意义(t值分别为0.978、2.032、1.257、0.891、2.182、2.271、1.329,P均＞0.05),但病例组ICU停留时间[(2.6±0.6)d]较对照组[(1.8±1.5)d]明显增长(t=2.704,P＜ 0.05).结论 G6PD缺乏症患者心脏体外循环手术时,加强围手术期处理效果较好.
目的 觀察葡萄糖-6-燐痠脫氫酶(G6PD)缺乏癥患者心髒體外循環圍手術期治療方法.方法 以2005年1月至2010年12月間在廣西桂林醫學院附屬醫院中進行心髒手術的10例G6PD缺乏癥確診患者作為病例組觀察對象.同期選取性彆、年齡、體質量、所患心髒手術疾病相匹配的20例非G6PD缺乏癥患者作為對照組觀察對象.病例組患者圍手術期治療措施集中于避免藥物引起的急性溶血反應,減少手術應激,採用淺低溫體外循環,加彊血液保護等.觀察指標包括患者圍手術期呼吸機輔助時間、尿量、胸管引流量、輸紅細胞懸液量、輸血漿量、術後第2天血紅蛋白和血總膽紅素水平,重癥鑑護病房(ICU)停留時間等.結果 病例組呼吸機輔助時間[(8.6±5.7)h]、尿量[(1950±490)ml]、胸管引流量[(260±l20)ml]、輸紅細胞懸液量[(1.8±1.2)U]、輸血漿量[(80±50)ml]、術後第2天血紅蛋白[(99±12) g/L]和總膽紅素水平[(27±11)μmol/L]與對照組比較[(9.3±4.5)h、(2100±670)ml、(253±146)ml、(1.3±1.0)U、(120±50)ml、(96±25)g/L、(24±8)μmol/L],差異均無統計學意義(t值分彆為0.978、2.032、1.257、0.891、2.182、2.271、1.329,P均＞0.05),但病例組ICU停留時間[(2.6±0.6)d]較對照組[(1.8±1.5)d]明顯增長(t=2.704,P＜ 0.05).結論 G6PD缺乏癥患者心髒體外循環手術時,加彊圍手術期處理效果較好.
목적 관찰포도당-6-린산탈경매(G6PD)결핍증환자심장체외순배위수술기치료방법.방법 이2005년1월지2010년12월간재엄서계림의학원부속의원중진행심장수술적10례G6PD결핍증학진환자작위병례조관찰대상.동기선취성별、년령、체질량、소환심장수술질병상필배적20례비G6PD결핍증환자작위대조조관찰대상.병례조환자위수술기치료조시집중우피면약물인기적급성용혈반응,감소수술응격,채용천저온체외순배,가강혈액보호등.관찰지표포괄환자위수술기호흡궤보조시간、뇨량、흉관인류량、수홍세포현액량、수혈장량、술후제2천혈홍단백화혈총담홍소수평,중증감호병방(ICU)정류시간등.결과 병례조호흡궤보조시간[(8.6±5.7)h]、뇨량[(1950±490)ml]、흉관인류량[(260±l20)ml]、수홍세포현액량[(1.8±1.2)U]、수혈장량[(80±50)ml]、술후제2천혈홍단백[(99±12) g/L]화총담홍소수평[(27±11)μmol/L]여대조조비교[(9.3±4.5)h、(2100±670)ml、(253±146)ml、(1.3±1.0)U、(120±50)ml、(96±25)g/L、(24±8)μmol/L],차이균무통계학의의(t치분별위0.978、2.032、1.257、0.891、2.182、2.271、1.329,P균＞0.05),단병례조ICU정류시간[(2.6±0.6)d]교대조조[(1.8±1.5)d]명현증장(t=2.704,P＜ 0.05).결론 G6PD결핍증환자심장체외순배수술시,가강위수술기처리효과교호.
Objective To observe the perioperative management of cardiac surgery and extracorporeal circulation method in patients with glucose-6-phosphate dehydrogenase deficiency(G6PD).Methods Ten patients with G6PD deficiency underwent uneventful cardiac surgery procedures between January 2005 and December 2010.Twenty patients who had non-G6PD deficiency were as a control group,the selected conditions were the same gender,age,body mass,the risk of heart disease surgery.The preoperative management in patients with G6PD deficiency mainly focused on avoiding the drugs implicated in haemolysis,reducing the surgical stress,using moderate hypothermia extracorporeal circulation and enhancing blood conservation.Observed indicators included the assisted ventilation time,urine volume,the drainage volume of chest tube,the amount transfusion of red blood cells and plasma,the level of hemoglobin and serum total bilirubin in the 2nd day after surgery,ICU stay.Results Compared with the control group,patients with G6PD deficiency had no significant difference in duration of ventilation after the operation,drainage,urine,Hgb,bilirubin levels,and blood transfusion[(9.3 ± 4.5)h vs (8.6 ± 5.7)h,(2100 ±670)ml vs (1950 ± 490) ml,(253 ± 146)ml vs (260 ± 120)ml,(1.3 ± 1.0)U vs (1.8 ± 1.2)U,(96 ± 25)g/L vs (99 ± 12)g/L,and (24 ± 8)μmol/L vs (27 ± 1 l)μmol/L,t =0.978,2.032,1.257,0.891,2.182,2.271,and 1.329,all P ＞ 0.05].The duration of ICU discharge was significantly longer in the glucose-6-phosphate dehydrogenase deficient group[ (2.6 ± 0.6)d vs (1.8 ± 1.5)d,t =2.704,P ＜ 0.05].Conclusions Cardiac surgery can be performed safely in patients with G6PD deficiency with enhanced perioperative management.
