中国体外循环杂志2025，Vol.23Issue(2)：101-107,7.DOI:10.13498/j.cnki.chin.j.ecc.2025.02.03
心脏停搏液在A型主动脉夹层手术中应用的临床效果研究
Application of del Nido cardioplegia in type A aortic dissection surgery
摘要
Abstract
Objective To compare the efficacy of del Nido cardioplegia(DNC)and conventional blood cardioplegia(BCP)in myocardial protection during emergency surgery for acute type A aortic dissection.Methods A retrospective analysis was performed on 151 adults undergoing emergency ATAAD repair at Chengdu Third People's Hospital from January 2020 to August 2024.According to intraoperative cardioplegia,the patients were divided into BCP(n=95)and DNC(n=55)groups.Propensity scorematching(1:1)generated 32 matched pairs with balanced baseline characteristics.Primary endpoints were postoperative 48-hour creatine kinase-MB(CK-MB)and hy-sensitivity troponin T(HS-TnT).Secondary endpoints included postoperative 48-hour lactate dehydrogenase(LDH),creatine kinase(CK),α-hydroxybutyrate dehydrogenase(α-HBDH),left ventricular ejection fraction(LVEF%),mechanical ventilation duration,and ICU stay.A subgroup analysis focused on preoperative myocardial injury(serum CK-MB>4.87 μg/L).Results After matching,no significant differences were observed in 48-hour CK-MB or hs-TnT between BCP and DNC groups(P>0.05).Secondary outcomes,including LVEF,mechanical ventilation time,and ICU stay were comparable.In the preoperative myocardial injury subgroup(BCP:n=66;DNC:n=19),CK-MB(P=0.086)and hs-TnT(P=0.103)remained nonsignificant.However,DNC demonstrated significantly lower postoperative CK(P=0.042)and LDH(P=0.001)compared to BCP.Conclusion DNC and BCP provide equivalent myocardial protection in ATAAD surgery.However,DNC may reduce postoperative myocardial enzyme release in patients with preoperative injury,suggesting its preferential use in high-risk cohorts.关键词
体外循环/del Nido停搏液/含血停搏液/急性A型主动脉夹层/心肌保护Key words
Extracorporeal circulation/Del Nido cardioplegia/Blood-containing cardioplegia/Acute type A aortic dissection/myocardial protection引用本文复制引用
高兰英,薄致远,陈剑,陈杰,王伟,何琳,贾彬..心脏停搏液在A型主动脉夹层手术中应用的临床效果研究[J].中国体外循环杂志,2025,23(2):101-107,7.基金项目
四川省自然科学基金(面上项目)(2024NSFSC0646) （面上项目）
