心内直视手术患者心肺转流期间PCO_2间隙和胃粘膜pH的变化  

The changes of PCO_2gap and gastric intramucosalpH during cardiopulmonary bypassin patients undergoing open heart surgery

作　　者：詹英[1] 王丽娜[1] 李健[1] 杨建平[1] 

机构地区：[1]苏州大学附属第一医院麻醉科,215006

出　　处：《江苏医药》2005年第10期746-747,共2页Jiangsu Medical Journal

摘　　要：目的观察胃粘膜二氧化碳分压(PgCO2)与动脉血二氧化碳分压(PaCO2)之差PCO2间隙(PCO2gap)以及胃粘膜pH(i-pH)值在心内直视手术心肺转流(CPB)期间的监测作用.方法 15例心内直视手术病人,于手术开始时、CPB 30～45 min、心脏复跳后30 min和手术结束时测定PgCO2、PaCO2和i-pH值,计算PCO2gap.结果与转流前比较,CPB期间i-pH值显著降低(P＜0.05),PCO2gap显著增高(P＜0.01);心脏复跳后,这些改变甚至更明显(P＜0.05).结论临床CPB期间确实存在胃粘膜低灌流和酸中毒,胃粘膜产生CO2增加,且此低灌流状态于循环恢复后仍持续存在.PCO2gap和i-pH监测在CPB病人中的组织集合.Objective To investigate the changes of gastric intramucosal PCO2gap （PgCO2-PaCO2）and gastric intramucosal pH（i-pH） during cardiopulmonary bypass（CPB）. Methods A clinical study was carried out in 15 patients undergoing open heart surgery. PgCO2 ,PaCO2 and i-pH were measured and PCO2 gap was calculated before CPB, 30-45 min during CPB, at 30 min after recovery of heart beating and at the end of operation. Results Compared with those before CPB, i-pH decreased （P〈0.05） and PCO2gap increased （P〈0.01） significantly during CPB, which existed and were even worse （P〈0. 05）. Conclusion There were gastric mucosal hypoperfusion and acidosis during CPB, which existed continually after circulation resumed. The gastric intramucosal PCO2gap and i-pH monitoring during CPB is beneficial to the evaluating of tissue oxygenation.

关 键 词：PCO2间隙 胃粘膜PH 心肺转流 心内直视手术 PCO2 转流期间 手术患者 间隙 动脉血二氧化碳分压 胃粘膜二氧化碳分压 

分 类 号：R654.2[医药卫生—外科学] R614.2[医药卫生—临床医学]