| 摘要: |
| ［摘要］ 目的 观察七氟醚对小儿心脏手术围术期炎症反应的影响及其心肌保护的效果。方法 选择24例择期行先天性心脏病手术的患儿，随机分成实验组（S组）和对照组（C组），每组12例。S组在麻醉诱导气管插管后至夹闭主动脉前吸入七氟醚(呼气末浓度为2%), 而C组只吸入纯氧。分别于麻醉诱导前即刻(T0)、主动脉开放后20 min(T1)、停CPB 4 h(T2)、24 h(T3)采集桡动脉血，测定肿瘤坏死因子α(TNF-α)、血浆心肌肌钙蛋白I(cTnI)水平。结果 与T0时比较，两组T1～3时TNF-α和cTnI水平均升高（P <0.05）；与C组比较，S组T1～3时TNF-α浓度降低，T2～3时cTnI水平降低（P <0.05）。cTnI与TNF-α呈正相关，相关系数r为0.67。结论 七氟醚预处理通过抑制炎症反应，对小儿CPB患者心肌产生一定的保护作用。 |
| 关键词: 七氟醚 预处理 体外循环 肿瘤坏死因子α 肌钙蛋白I |
| DOI：10.3969/j.issn.1674-3806.2009.06.13 |
| 分类号:R 614.2 |
| 基金项目: |
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| The cardioprotective effects of sevoflurane preconditioning in children undergoing cardiac surgery |
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HE Bing-hua, JIANG Ying
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Department of Anesthesiology, Shaoyang Central Hospital, Shaoyang Hunan 422000, China
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| Abstract: |
| ［Abstract］ Objective To investigate the effect of sevoflurane preconditioning on plasma TNF-α levels in children undergoing cardiac surgery with cardiopulmonary bypass(CPB).Methods Twenty-four ASA Ⅰ or Ⅱ patients (11 male, 13 female) aged 0.9～12years, weight 6～26 kg, were randomly allocated to one of two groups (n=12 each):experimental group (group S) and control group (group C).In group S, the patients were inhaled 2% sevoflurane from anesthesia induction until aortic cross clamping while in group C the patients were inhaled only 100% O2.Blood samples were obtained from radial artery before induction of anesthesia(T0), 20 min after aortic unclamping(T1), 4 h(T2) and 24 h(T3) after CPB for determination of plasma levels of TNF-α and cTnI.Results Plasma levels of TNF-α and cTnI were significantly increased at T1～3 as compared with the baseline values at T0 in both groups and were significantly lower in group S than in group C (P <0.05）. Conclusion Sevoflurane preconditioning can effectively inhibit the inflammatory response in children undergoing open heart operation with CPB. |
| Key words: Sevoflurane Preconditioning Cardiopulmonary bypass TNF-α cTnI |
