动脉血乳酸对心脏术后患者的病情评估作用

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动脉血乳酸对心脏术后患者的病情评估作用

王显悦1张卫达王晓武马涛梅鲁刚梁爱琼张琰

(广州军区总医院心脏外科中心,广东广州 510010)Pathogenetic condition evaluation effect of arterial blood lactic acid on postcardiotomy patients

WANG Xian-yue,ZHANG Wei-da,WANG Xiao-wu,MA Tao,MEI Lu-gang,LIANG Ai-qiong,ZHANG Yan

Department of Cardiovascular Surgery, the Military General Hospital of Guangzhou Command, Guangzhou Guangdong 510010, China

Corresponding author: WANG Xian-yue

【Abstract】Objective:To identify the pathogenetic condition evaluation effect of arterial blood lactic acid on postcardiotomy patients. METHODS:62 postcardiotomy patients were divided into two groups according to arterial blood lactic acid values. The value of 2.0 mmol/L at ICU admission was chosen as the section point for arterial blood lactic acid. The patients with the mean value of less than 2.0 mmol/L (group A) were compared with the remaining patients (group B) on length of ICU stay, ventilation time and frequency of vasoactive agent and alkaline drug use. The recovery of patients and variation tendency of arterial blood lactic acid, PH and BE were recorded from two groups.RESULTS:In group A, there was one case to which left pulmonary atelectasis occurred. One patient died of low output syndrome in group B. Compared with group A , group B had longer ventilation time and the length of ICU stay (P < 0. 05) ,and higher frequency of vasoactive agent and alkaline drug use ( P < 0. 05). Group B had a greater fluctuation on the value of postoperative arterial blood lactic acid, PH and BE. These values fluctuated most 5 hours after operation and regressed gradually back to the normal 15-20 hours after operation. CONCLUSION:The value of Arterial blood lactic acid can be used to evaluate pathogenetic condition of postcardiotomy patients to a certain extent. Patients with high level of arterial blood lactic acid have an unstable pathogenetic condition in earlier postoperation. They need more drugs to maintain vital sign and homeostasis and have a longer postoperative recovery.

【Key words】Lactic acid ;postcardiotomy ;pathogenetic condition evaluation

【摘要】目的:明确动脉血乳酸对于心脏术后患者的病情评估作用。方法:随机抽取62例心脏术后患者,选择入监护室即时动脉血乳酸低于2.0mmol/L的30例患者分为A组,余32例为B组。比较两组患者呼吸机辅助时间、监护室滞留时间以及血管活性药物和碱性药物使用情况。观察两组患者术后恢复情况和动脉血乳酸、酸碱度和碱剩余的变化趋势。结果:A 组1例患者术后左肺不张;B组1例患者因术后低心排综合征死亡。与A组比较,B组患者手术

1通讯作者:王显悦. Tel: (020) 36654575Email: nnnd@http://m.wendangku.net/doc/074827eccfc789eb162dc80a.html

作者简介:王显悦. 硕士,主治医师.

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