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血液停搏液与德尔尼多停搏液对接受单纯冠状动脉搭桥术患者术后重症监护需求、引流量及肾功能影响的比较

Comparison of the Effects of Blood Cardioplegia and Del Nido Cardioplegia on Postoperative Intensive Care Needs, Drainage, and Renal Functions in Patients Undergoing Isolated Coronary Artery Bypass.

作者信息

Sarıgol Yaşar, Yıldırım Serkan, Işık Mehmet, Tanyeli Omer, Dereli Yuksel, Ege Erdal, Gormuş Niyazi

机构信息

Department of Cardiovascular Surgery, Necmettin Erbakan University Faculty of Medicine Hospital, Konya, Turkey.

出版信息

Braz J Cardiovasc Surg. 2025 Jun 4;40(4):e20240237. doi: 10.21470/1678-9741-2024-0237.

Abstract

OBJECTIVE

A variety of cardioplegia techniques with different components are implemented to ensure myocardial protection, in addition to keeping the operationa field immobile and free of blood during cardiac surgery. The implemented cardioplegia has unwanted negative effects on other end organs. In this study, our aim was to compare the effects of Del Nido cardioplegia and blood cardioplegia solutions on postoperative intensive care duration, drainage, and renal functions for patients undergoing cardiopulmonary bypass and bypass graft operations.

METHODS

Selections were made from patients undergoing elective bypass graft operations in our clinic from January 1, 2022 to December 31, 2023. Patients were randomly selected, retrospectively assessed, and divided into two groups - De Nido group (Group 1) and blood cardioplegia group (Group 2). Comparisons were made between these groups in terms of intensive care duration, drainage, and renal functions.

RESULTS

The study included 120 patients. The Del Nido cardioplegia group included 60 patients, with 60 patients in the blood cardioplegia group. Comparisons between the groups found that the aortic cross-clamping duration was significantly high in Group 1 (P = 0.014). The noradrenaline dose given to Group 1 was high (P = 0.004). In terms of renal injury, significant degree of elevation was present in Group 1 (P = 0.027). The longer aortic cross-clamping duration in Group 1 may be assessed as a determinant factor for noradrenaline dose and acute kidney injury.

CONCLUSION

This study concluded that it willbe appropriate to choose the cardioplegia method by performing broader meta-analysis studies and minimizing limiting factors.

摘要

目的

除了在心脏手术期间保持手术视野静止且无血外,还采用了多种成分不同的心脏停搏技术来确保心肌保护。所实施的心脏停搏对其他终末器官有不良负面影响。在本研究中,我们的目的是比较德尔尼多心脏停搏液和血液心脏停搏液对接受体外循环和搭桥手术患者术后重症监护时长、引流量和肾功能的影响。

方法

选取2022年1月1日至2023年12月31日在我院接受择期搭桥手术的患者。对患者进行随机选取、回顾性评估,并分为两组——德尔尼多组(第1组)和血液心脏停搏液组(第2组)。比较两组在重症监护时长、引流量和肾功能方面的情况。

结果

该研究纳入120例患者。德尔尼多心脏停搏液组有60例患者,血液心脏停搏液组有60例患者。组间比较发现,第1组的主动脉阻断时间显著更长(P = 0.014)。给予第1组的去甲肾上腺素剂量更高(P = 0.004)。在肾损伤方面,第1组有显著程度的升高(P = 0.027)。第1组较长的主动脉阻断时间可能被视为去甲肾上腺素剂量和急性肾损伤的决定因素。

结论

本研究得出结论,通过进行更广泛的荟萃分析研究并尽量减少限制因素来选择心脏停搏方法将是合适的。

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