非泵式冠状动脉旁路移植术患者急性左心室衰竭治疗的代谢成分

V. Cherniy, Y. Kurylenko
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摘要

目的:探讨左旋肉碱与精氨酸联合应用对心脏手术合并急性左心室衰竭行CABG合并体外循环(CPB)治疗效果的影响。材料与方法:手术患者500例。所有患者均行冠脉搭桥伴CPB。选择60例术后需要肌力支持的患者。这些病人被分成两组,每组30人。在基础组中,使用多巴酚丁胺的肌力支持和左卡尼汀和精氨酸联合的代谢支持来稳定血流动力学。对照组仅用多巴酚丁胺稳定。结果:基础组血流动力学稳定期静脉饱和度较高。基础组血流动力学恢复时间和肌力药物总剂量均低于对照组。结论:两组患者均达到了血流动力学稳定的过程。左卡尼汀与精氨酸联用对心肌有明显的抗缺氧作用。联合用药可使血流动力学恢复时间缩短1.3倍,肌力药物总剂量减少1.33倍。
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Metabolic component of acute left ventricular failure treatment in patients who underwent on-pump coronary artery bypass grafting
Aim: To study the effectiveness of the use of a combination of L-carnitine and arginine to improve the results of treatment of cardiac surgery patients with acute left ventricular failure who underwent CABG with cardiopulmonary bypass (CPB). Material and methods: 500 patients were operated. All of them underwent CABG with CPB. Sixty patients who required inotropic support in the postoperative period were selected. The patients were divided into two groups of 30 people each. Inotropic support with dobutamine and metabolic support with a combination of levocarnitine and arginine were used to stabilize hemodynamics in the basic group. Stabilization was performed with dobutamine alone in the control group. Results: The venous saturation during the period of hemodynamic stabilization was higher in basic group. In the basic group, the recovery time of hemodynamics and the total dose of the inotropic drug were shorter/lower than in the control one. Conclusions: The groups of patients were homogeneous and the process of hemodynamic stabilization was achieved in both groups. The combination of Levocarnitine and Arginine has a pronounced antihypoxic effect on the myocardium. Using this combination can reduce the hemodynamic recovery time by 1.3 times and reduce the total dose of the inotropic drug by 1.33 times.
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