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目的通过体外循环(CPB)期间乳酸及氧代谢指标的变化,探明CPB期间组织氧代谢的状况。方法6~10岁紫绀先心病患儿10例,于手术开始前、CPB前1~3s、CPB30s、复温34℃、CPB停止后1~3s、术毕,6个时点取动、静脉血测Hb、SaO2、PaO2、SvO2、PvO2及动脉乳酸值。结果CPB开始后乳酸值开始升高,复温时乳酸达峰值,以后渐渐回落。转流30s、复温34℃、停机,术毕的乳酸值与手术开始前相对比均差异有统计学意义(P<0·05)。结论CPB期间机体存在着组织摄氧能力下降,应改善微循环,给予充足的氧供。
Objective To investigate the changes of tissue oxygen metabolism during CPB through the changes of lactic acid and oxygen metabolism indexes during cardiopulmonary bypass (CPB). Methods Ten children aged 6 ~ 10 years with cyanotic congenital heart disease were treated with venous blood before surgery, 1 ~ 3 seconds before CPB, 30 seconds after CPB, 34 ℃ rewarming, 1 ~ 3 seconds after CPB stopped, Measure Hb, SaO2, PaO2, SvO2, PvO2 and arterial lactate value. Results After the start of CPB, the lactic acid value began to rise, and the lactic acid peaked after rewarming, then gradually decreased. After 30 seconds of reflow and rewarming at 34 ℃, the lactic acid value at the end of surgery was significantly lower than that before surgery (P <0.05). Conclusion During the period of CPB, there is a decrease in tissue oxygen uptake in the body. Microcirculation should be improved to provide adequate oxygen supply.