Clinical Assessment of Histidine-Tryptophan-Ketoglutarate Solution and Modified St. Thomas' Solution in Pediatric Cardiac Surgery of Tetralogy of Fallot
Clinical Assessment of Histidine-Tryptophan-Ketoglutarate Solution and Modified St. Thomas' Solution in Pediatric Cardiac Surgery of Tetralogy of Fallot
复制标题
组氨酸-色氨酸-酮戊二酸溶液和改良圣托马斯溶液在法洛四联症小儿心脏手术中的临床评估
DOI：
10.1111/aor.12771
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发表时间：
2017-05-01
影响因子：
2.4
通讯作者：
Yang, Li-Qun
中科院分区：
文献类型：
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作者：
Wang, Zhao-Hui;An, Yong;Yang, Li-Qun
本研究的目的是比较Bretschneider的组氨酸-色氨酸-酮戊二酸（HTK）溶液与改良St.托马斯（STH）溶液在小儿法洛四联症（TOF）心脏手术中的心肌保护作用。回顾了2014年1月至2015年10月期间接受全手术修复的77例TOF儿科患者。自HTK液在我院使用以来，对HTK液与改良STH液进行了横向比较。将患者分为HTK组（n = 35）和STH组（n = 33）。在本研究中评估了各组的围手术期值。本研究分析了主要终点，包括自发心脏复跳时间、重症监护室（ICU）住院时间、总住院时间、术后机械通气时间、术后住院时间、总住院时间和围手术期超声心动图结果。我们发现HTK组的自发心脏复跳时间明显短于STH组（0.26 min +/- 60.56 vs. 1.33 min +/- 61.02，P < 0.001）。两组在ICU住院时间（P = 0.29）、术后机械通气时间（P = 0.84）、总住院时间（0.73）方面无显著差异;两组死亡率相似（2.9vs.3.0%）。本研究针对小儿TOF心脏手术，提示在主动脉阻断时间相近的情况下，改良STH液与HTK液同样安全。
The objective of this study is to compare the myocardium protective effect of Bretschneider's histidine-tryptophan- ketoglutarate (HTK) solution versus Modified St. Thomas' (STH) solution in pediatric cardiac surgery of Tetralogy of Fallot (TOF). Seventy-seven pediatric patients of TOF who received the total surgical repair were reviewed, from January 2014 to October 2015. A horizontal comparison between HTK solution and modified STH solution has been made since the HTK solutions were started to be used in our hospital. The patients were divided into the HTK group (n = 35) and the STH group (n = 33). The perioperative values of the groups were assessed in this study. The primary endpoints including spontaneous cardiac re-beating time, intensive care unit (ICU) stay, overall stay, mechanical ventilation postoperation, postoperation stay, overall stay, and perioperative echocardiographic results were analyzed in this study. We found that spontaneous cardiac re-beating time of the HTK group was significantly shorter than that of the STH group (0.26 min +/- 60.56 vs. 1.33 +/- 61.02, P < 0.001). There were no significant differences between the two groups in ICU stay (P = 0.29), postoperative mechanical ventilation time (P = 0.84), overall stay (0.73); and the mortalities of the two groups were similar (2.9 vs. 3.0%). Aimed at pediatric cardiac surgery of TOF, this study suggests that with similar aorta cross-clamping time, modified STH solution is as safe as HTK solution.