|
| HA380血液灌流治疗对心肺转流心脏手术患者术后谵妄的影响 |
| Effect of HA380 haemoperfusion therapy on postoperative delirium in patients undergoing cardiac surgery with cardiopulmonary bypass |
| |
| DOI：10.12089/jca.2025.08.005 |
| 中文关键词: 心脏手术 心肺转流 术后谵妄 血液灌流 |
| 英文关键词: Cardiac surgery Cardiopulmonary bypass Postoperative delirium Hemoperfusion |
| 基金项目:新疆维吾尔自治区研究生创新项目（XJ2024G150）；新疆维吾尔自治区卫生健康委员会青年医学科技人才项目（WJWY-202459） |
| 作者 | 单位 | E-mail | | 程虎 | 830054, 乌鲁木齐市, 新疆医科大学第一附属医院麻醉科,新疆省围术期器官保护重点实验室 | | | 李雪燕 | 830054, 乌鲁木齐市, 新疆医科大学第一附属医院麻醉科,新疆省围术期器官保护重点实验室 | | | 程逍 | 830054, 乌鲁木齐市, 新疆医科大学第一附属医院麻醉科,新疆省围术期器官保护重点实验室 | | | 亚力·亚森 | 830054, 乌鲁木齐市, 新疆医科大学第一附属医院麻醉科,新疆省围术期器官保护重点实验室 | | | 吴建江 | 830054, 乌鲁木齐市, 新疆医科大学第一附属医院麻醉科,新疆省围术期器官保护重点实验室 | | | 王江 | 830054, 乌鲁木齐市, 新疆医科大学第一附属医院麻醉科,新疆省围术期器官保护重点实验室 | 710985359@qq.com |
|
| 摘要点击次数: 1405 |
| 全文下载次数: 420 |
| 中文摘要: |
目的： 评价HA380血液灌流治疗对心肺转流（CPB）心脏手术患者术后谵妄（POD）的影响。
方法：本研究采用前瞻性队列研究设计，选择2024年1—12月于CPB下行心脏手术的患者206例，男120例，女86例，年龄37～75岁，BMI 18.5～32.0 kg/m2，ASA Ⅲ或Ⅳ级，手术类型包括冠状动脉搭桥术、心脏瓣膜置换术或冠状动脉搭桥心脏瓣膜置换联合手术。根据术中是否使用HA380血液灌流治疗将患者分为两组：HA组(n=82)与对照组(n=124)。记录术后7 d内术后认知功能障碍的发生情况及持续时间及术后1个月的认知功能。记录术后机械通气时间、术后ICU治疗时间、术后住院时间、术后并发症的发生情况。于切皮前、术后6、24、48 h采用ELISA法检测血浆炎性因子白细胞介素-6（IL-6）、白细胞介素-8（IL-8）、肿瘤坏死因子-α（TNF-α）及脑损伤标记物tau、胶质纤维酸性蛋白（GFAP）浓度。
结果：与对照组比较，HA组术后7 d内POD发生率明显降低（P< 0.05），术后6 h IL-6、IL-8、TNF-α和GFAP蛋白浓度明显降低（P< 0.05），术后24 h IL-6、IL-8、TNF-α、tau和GFAP蛋白浓度明显降低（P< 0.05），术后48 h IL-6、TNF-α和tau蛋白浓度明显降低（P< 0.05）。两组术后机械通气时间、术后ICU治疗时间、术后住院时间、术后并发症发生率差异无统计学意义。
结论：CPB心脏手术患者使用HA380血液灌流治疗能够降低术后炎性因子及脑损伤标记物浓度，降低POD发生率。 |
| 英文摘要: |
Objective: To evaluate the effect of HA380 haemoperfusion therapy on postoperative delirium (POD) in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB).
Methods: A total of 206 patients underwent cardiac surgery under CPB from January to December 2024, 120 males and 86 females, aged 37-75 years, BMI 18.5-32.0 kg/m2, ASA physical status Ⅲ or Ⅳ, were enrolled in this prospective cohort study. The types of surgery included coronary artery bypass grafting, cardiac valve replacement, or combined coronary artery bypass graft cardiac valve replacement. Patients were divided into two groups according to whether HA380 haemoperfusion therapy was used intraoperatively: the HA group (n = 82) and the control group (n = 124). The incidence and duration of POD within 7 days after surgery, and cognitive function at 1 month postoperatively were assessed and recorded. The plasma concentrations of interleukin-6 (IL-6), interleukin-8 (IL-8), tumor necrosis factor-α (TNF-α), tau and glial fibrillary acidic protein (GFAP) were detected by ELISA before surgical skin incision, 6, 24, and 48 hours after surgery, respectively. The duration of postoperative mechanical ventilation, postoperative ICU stay time, postoperative hospital stay time, and postoperative complication rate were recorded.
Results: Compared with the control group, the incidence of POD within 7 days surgery was significantly lower in the HA group (P < 0.05), the concentrations of IL-6, IL-8, TNF-α, and GFAP proteins were significantly lower at 6 hours postoperatively (P < 0.05), the concentrations of IL-6, IL-8, TNF-α, tau, and GFAP proteins were significantly lower at 24 hours postoperatively (P < 0.05), and IL-6, TNF-α, and tau protein concentrations were significantly lower at 48 hours postoperatively (P < 0.05). There were no statistically significant differences between the two groups in terms of postoperative mechanical ventilation time, postoperative ICU stay time, postoperative hospital stay time, and the incidence of postoperative complications.
Conclusion: Patients undergoing CPB cardiac surgery treated with HA380 haemoperfusion reduces postoperative levels of inflammatory factors and markers of brain damage as well as the risk of POD. |
|
查看全文
查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|
