冠心病冠脉搭桥术围术期的氧转运和氧消耗  

Perioperative oxygen transport and oxygen consumption during coronary artery bypass grafting procedure

作　　者：吴新民[1] 王东信[1] 许幸[1] 朱姜华 刘岩[2] 张希涛[2] 

机构地区：[1]北京医科大学第一医院麻醉科,100034 [2]北京朝阳医院心外科

出　　处：《中华麻醉学杂志》1998年第6期331-333,共3页Chinese Journal of Anesthesiology

摘　　要：目的:了解冠状动脉搭桥术围术期的氧合状态。方法:测定了55例采用咪唑安定、芬太尼和维库溴铵诱导,芬太尼及异氟醚维持麻醉接受冠状动脉搭桥术的病人诱导后、终止体外循环、术终和术后1日的心脏指数(CI)、氧转运(TO_2)、氧耗量(VO_2)、氧摄取率(O_2ER)以及血乳酸水平。结果:终止体外循环、术终和术后1日TO_2和VO_2之间存在着明显的相关关系(r分别为0.7817、0.559和0.7754,P<0.01)。其中测定了12例病人血中乳酸浓度显示,停机后乳酸显著升高(3.50±2.30mmol/L,P<0.05)。结论:冠脉搭桥术围术期呈现出氧耗的供给依赖性关系,冠脉搭桥手术结束时,氧耗量增加,术后1日仍处于高代谢状态。To investigate the perioperative oxygenation of the patient undergoing coronary artery bypass grafting procedure (CABG). Method: The relationship between oxygen transport (TO_2) and oxygen consumption (VO_2), and serum lactate level were examined in 55 patients undergoing CABF, anesthetized with midazolam, vecuronium and a moderate dose of fentanyl. Result: Good correlations between TO_2 and VO_2 at the weaning from CPB (r=0.7817, P<0.01), the end of the procedure(r=0.5597, P<0.01)and one day post operation (r=0.7754, P<0.01) were shown respectively. Serum lactate level was higher (3.50±2.30 mmol/L, P<0.01) at the weaning from CPB than that at the end of the operation and one day post operation in 12 patients undergoing CABG. Conclusion: Oxygen supply-consumption dependency exists in the perioperative period of CABG. It is important for avoiding the inadequacy of tissue oxygenation to improve TO_2 during and after CPB, cspecially immediately weaning from CPB.

关 键 词：冠脉动脉分流 氧转运 氧消耗 冠心病 

分 类 号：R654.205[医药卫生—外科学]