Myocardial Protective Effect Of Limb Ischemic Postprocessing Of Surgical Ventricular Septal Defect

Objective:To investigate the protective effect of limb ischemic postconditioning in patients with ventricular septal defect after surgery.Methods:60 patients with congenital heart disease were randomly divided into two groups,treatment group(group A) and control group(group B), 30 patients in each group.The two groups of patients in anesthesia, surgery, cardiopulmonary bypass methods,breathing patterns, respiratory parameters and the same oxygen concentration and other aspects of the same. Treatment group in intracardiac operation is completed,opening of aorta was given immediately remote limb ischemic postconditioning,specific operation: tourniquet wrapped in the right upper arm/3, inflatable blocking right upper limb blood supply to maintain for 5 min, then deflated continued for 5min, recover the right upper limb blood supply, so the cycle 3 times(the charging pressure according to the following formula calculation: tourniquet pressure in kPa =8.116+0.830 x limb of the circumference); the control group was not given limb ischemic postconditioning. Patients of the two groups respectively before aortic cross clamping(T1), after opening aorta 1h(T2), 6h(T3), 24h(T4) by central venous blood3 ml are centrifuged(3000 rpm), serum under-20 DEG C low-temperature refrigerator preservation by chemical method at each time point of cardiac troponin I(cTnI),creatine kinase isoenzyme(CK-MB), superoxide dismutase(SOD) and malondialdehyde(MDA) determination. At the same time, the mechanical ventilation time, the duration of stay in intensive care unit and the number of deaths were recorded in the four groups. All data were to( X ±S) said, using SPSS statistical software for statistical analysis, probability of less than 0.05 was considered statistically significant, less than 0.01 significant statistical significance.Results:The control group and the treatment group cTnI?CK-MB?MDA after CPB gradually increased, in each period of treatment group were lower than the control group, the two groups of patients in the postoperative T2?T3?T4 difference was statistically significant(P<0.05). SOD increased after operation in the two groups, the serum SOD activity was higher than the control group at T2?T3?T4(P<0.05).Conclusion:Limb ischemic postconditioning the mechanism may include inhibition of inflammatory response and lipid peroxidation, it can provide myocardial protective effects for congenital heart surgery and the limb ischemic postconditioning method is applied in clinic to provide a certain reference value.