CAJ | 학술논문

目的：回顾性分析大血管手术中采用康斯特保护液（ HTK液）与含血停搏液的心肌保护效果，为临床合理使用心脏停搏液提供依据。方法回顾性分析2003年4月至2006年12月100例采用多次灌注含血停搏液的大血管手术患者作为含血停搏液组（ BC组），2014年1月至2014年7月100例使用单次灌注HTK液的大血管手术患者作为HTK液组（ HTK组）。采用倾向评分匹配方法在上述资料中选择合适病例进行匹配，消除体外循环时间上的差异。共获得BC组43例与HTK组43例配对。结果 BC组平均阻断时间为（102±40）min；HTK组阻断时间为（103±31） min（ P ＝0．87）。主动脉开放后两组心脏自动复跳率没有差别。血心肌型肌酸激酶同功酶在手术当天显著增高，术后第1d、2d逐渐回落，统计显示两组之间没有差异。术后两组血管活性药物的使用也无差异。两组患者均无死亡。结论 HTK液在大血管手术中的心肌保护效果同含血停搏液多次灌注一致。单次灌注HTK液具有简化外科操作的临床优越性。
목적：회고성분석대혈관수술중채용강사특보호액（ HTK액）여함혈정박액적심기보호효과，위림상합리사용심장정박액제공의거。방법회고성분석2003년4월지2006년12월100례채용다차관주함혈정박액적대혈관수술환자작위함혈정박액조（ BC조），2014년1월지2014년7월100례사용단차관주HTK액적대혈관수술환자작위HTK액조（ HTK조）。채용경향평분필배방법재상술자료중선택합괄병례진행필배，소제체외순배시간상적차이。공획득BC조43례여HTK조43례배대。결과 BC조평균조단시간위（102±40）min；HTK조조단시간위（103±31） min（ P ＝0．87）。주동맥개방후량조심장자동복도솔몰유차별。혈심기형기산격매동공매재수술당천현저증고，술후제1d、2d축점회락，통계현시량조지간몰유차이。술후량조혈관활성약물적사용야무차이。량조환자균무사망。결론 HTK액재대혈관수술중적심기보호효과동함혈정박액다차관주일치。단차관주HTK액구유간화외과조작적림상우월성。
[ Abstract]:Objective To compare myocardial protective effects between HTK solution and blood cardioplegia in the aortic sur?gery. Methods One hundred cases of aortic surgery accepted multiple-dose blood cardiaplegia from 2003 April to 2006 December were divided into blood cardioplegia group ( BC group) , and other 100 cases with single-dose of HTK solution from 2014 January to 2014 July into HTK solution group ( HTK group) . The appropriate cases were selected in those cases to eliminate the difference of by?pass time with propensity-score matching method. A total of 43 cases in BC group and 43 cases in HTK group were matched. Results Average aortic cross-clamping time was 102±40 min in BC group and 103±31 min in HTK group ( P =0.87). The rate of heart beating spontaneously after cross-clamping released was similar between two groups. Serum CKMB levels increased significantly in two groups at operative day and then decreased gradually in postoperative 2 days, there was no significant difference between two groups. The vasoactive drugs also had no difference between two groups. No death occurred in two groups. Conclusion Myocardial protective effect of single-dose HTK solution in aortic surgery is similar to that of multiple-dose of blood cardioplegia. A single-dose of HTK so?lution is benefit for simplifying the aortic surgical procedures.