CAJ | 학술논문

目的：探讨心肌肌钙蛋白I(cTnI)和心肌酶在背驮式肝移植术麻醉中的表达及意义。方法选取本院2007年1月~2013年1月行同种异体原位肝移植术的14例患者作为研究对象,分别于切皮时、阻断门静脉30 min、开放门静脉30 min、术毕、术后24 h和术后48 h抽取静脉血测定cTnI、CK和CK-MB水平。结果开放门静脉30 min、术毕时的cTnI水平显著高于切皮时,差异有统计学意义(P<0.05)。术后24、48 h的CK水平显著高于切皮时,差异有统计学意义(P<0.01)。开放门静脉30 min、术毕时的CK-MB水平显著高于切皮时,差异有统计学意义(P<0.05),而且数据均大于正常值。14例患者术中心电监护无明显心肌缺血改变,术后48 h随访无心脏不良并发症。结论在背驮式肝移植术中,cTnI比CK、CK-MB反映心肌损伤的特异性更高,更准确可靠,本研究患者围术期均无明显心肌损伤。
목적：탐토심기기개단백I(cTnI)화심기매재배타식간이식술마취중적표체급의의。방법선취본원2007년1월~2013년1월행동충이체원위간이식술적14례환자작위연구대상,분별우절피시、조단문정맥30 min、개방문정맥30 min、술필、술후24 h화술후48 h추취정맥혈측정cTnI、CK화CK-MB수평。결과개방문정맥30 min、술필시적cTnI수평현저고우절피시,차이유통계학의의(P<0.05)。술후24、48 h적CK수평현저고우절피시,차이유통계학의의(P<0.01)。개방문정맥30 min、술필시적CK-MB수평현저고우절피시,차이유통계학의의(P<0.05),이차수거균대우정상치。14례환자술중심전감호무명현심기결혈개변,술후48 h수방무심장불량병발증。결론재배타식간이식술중,cTnI비CK、CK-MB반영심기손상적특이성경고,경준학가고,본연구환자위술기균무명현심기손상。
Objective To explore the expression and significance of cardiac troponin I and myocardial enzyme in the anesthesia of piggy-back orthotopic liver transplantation. Methods 14 cases with orthotopic liver transplantation from January 2007 to January 2013 in our hospital were selected as the research objects.The level of cardiac troponin I (cTnI),CK and CK-MB at points-skin incision,clamping the portal vein for 30 min,unclamping the portal vein for 30 min,end of operation,postoperative 24 and 48 h was measured respectively. Results The level of cTnI at clamping the portal vein for 30 min and end of operation was higher than that at points-skin incision,with significant difference (P<0.05).The level of CK after operation at 24,48 hours was higher than that at points-skin incision,with significant differ-ence(P<0.01).The level of CK-MB at clamping the portal vein for 30 min and end of operation was higher than that at points-skin incision,with significant difference (P<0.05),and all the level of CK-MB exceeded normal range.There was no obvious changes of myocardial ischemia in 14 patients,and no complication was followed up after 48 hours. Con-clusion During perioperation of piggy-back orthotopic liver transplantation,cTnI can reveal myocardial injury more ac-curately and responsibly than CK,CK-MB.There is no obvious myocardial injury in the perioperative period of this study.