CAJ | 학술논문

目的评价二尖瓣置换术患者体外循环(CPB)后早期左心室心肌舒张功能的变化.方法择期行CPB下二尖瓣置换术患者20例,年龄40 ～ 70岁,性别不限,ASA分级Ⅱ或Ⅲ级,NYHA分级2或3级,术前左心室射血分数(LVEF) ≥45％.采用经食管超声心动图测定左心室整体和局部舒张功能.于锯胸骨前(T0)和停CPB后30 min(T30)、90 min(T90)记录HR、MAP、CVP、心脏指数(CI)、LVEF、经二尖瓣口血流多普勒舒张早期充盈波峰值(E)、经二尖瓣环舒张早期运动峰值速度(Ea)、左心室前壁、后壁心肌舒张早期运动速度(Em)及舒张晚期运动速度(Am),并计算E/Ea比值和Em/Am比值.结果患者CPB前后各时点血流动力学和左心室舒张功能各指标比较差异无统计学意义(P＞0.05),患者各时点LVEF均大于50％,E/Ea比值均大于20.结论二尖瓣置换术患者CPB后早期左心室心肌舒张功能并未进一步受损.
목적 평개이첨판치환술환자체외순배(CPB)후조기좌심실심기서장공능적변화.방법 택기행CPB하이첨판치환술환자20례,년령40 ～ 70세,성별불한,ASA분급Ⅱ혹Ⅲ급,NYHA분급2혹3급,술전좌심실사혈분수(LVEF) ≥45％.채용경식관초성심동도측정좌심실정체화국부서장공능.우거흉골전(T0)화정CPB후30 min(T30)、90 min(T90)기록HR、MAP、CVP、심장지수(CI)、LVEF、경이첨판구혈류다보륵서장조기충영파봉치(E)、경이첨판배서장조기운동봉치속도(Ea)、좌심실전벽、후벽심기서장조기운동속도(Em)급서장만기운동속도(Am),병계산E/Ea비치화Em/Am비치.결과 환자CPB전후각시점혈류동역학화좌심실서장공능각지표비교차이무통계학의의(P＞0.05),환자각시점LVEF균대우50％,E/Ea비치균대우20.결론 이첨판치환술환자CPB후조기좌심실심기서장공능병미진일보수손.
Objective To evaluate the changes in early left ventricular myocardial diastolic function after cardiopulmonary bypass (CPB) in the patients undergoing mitral valve replacement.Methods Twenty patients of both sexes,aged 40-70 yr,of ASA physical status Ⅱ or Ⅲ (NYHA Ⅱ or Ⅲ),with left ventricular ejection fraction (LVEF) ≥ 45 ％,scheduled for elective mitral valve replacement with CPB,were enrolled in the study.Global and regional left ventricular diastolic function was measured by using TEE.After splitting of sternum and at 30 and 90 min after termination of CPB,HR,mean arterial pressure,central venous pressure,cardiac index,LVEF,early diastolic transmitral velocity (E),early diastolic tissue velocity (Ea),right ventricular early myocardial velocity (Em) and right ventricular late myocardial velocity (Am).E/Ea and Em/Am ratios were calculated.Results There was no significant difference in the parameters of hemodynamics and left ventricular diastolic function at each time point before and after CPB.LVEF was greater than 50％ and E/Ea ratio was greater than 20 at each time point in the patients.Conclusion There is no further damage to the early left ventricular myocardial diastolic function after CPB in the patients undergoing mitral valve replacement.