婴幼儿体外循环后血糖变化的初步研究  

Infants Blood Glucose Changes after Cardiopulmonary Bypass

作　　者：张斌[1] 吴继红[1] 王虎[1] 刘燕萍[1] 

机构地区：[1]宁夏医科大学附属医院心脏外科,银川750004

出　　处：《宁夏医科大学学报》2011年第3期246-248,共3页Journal of Ningxia Medical University

摘　　要：目的初步分析婴幼儿在体外循环术后血糖水平的变化规律及其影响因素。方法选择行心内直视手术患儿60例,按年龄、体重、体外循环时间分组。分为幼儿组（1~3岁）、婴儿组（≤1岁）,体重≤10kg（A组）、体重〉10kg组（B组）,体外循环时间〈60min（C组）、体外循环时间≥60min（D组）。观察患儿手术前（t0）,手术结束时（t1）,手术结束后1h（t2）、3h（t3）、5h（t4）血糖变化。结果体外循环术后各组血糖水平较转流前均明显升高;婴儿组与幼儿组相比手术结束时和术后1h血糖水平升高更明显;A组手术结束时和术后1、3h的血糖水平明显高于B组同时点血糖水平;D组手术结束和术后1h血糖水平明显高于C组同时点血糖水平。结论体外循环对小儿糖代谢有明显影响,体外循环期间糖代谢紊乱,血糖明显升高,且体外循环术对低龄、低体重、体外循环时间长的患儿血糖水平影响更大。Objective To investigate the changes of plasma glucose in infants undergoing open cardiac surgery during and after cardiopulmonary bypass（CPB）.Methods 60 cases＇ blood samples were taken at five different time points,before the operation（t0）,at the end of operation（t1）,1h after the operation（t2）,3h after the operation（t3）,and 5h after the operation（t4）.60 cases were divided into groups by age.Body weight and CPB time： the baby group（≤one-year-old） and the little children group（one-year-old to three-year-old）,the weight ≤10kg group（Group A） and the weight10kg group（Group B）,the CPB time60min group（Group C） and the CPB time≥60min group（Group D）.Results All groups＇ plasma glucose level significantly increased after the CPB.The plasma glucose level at t1 and t2 in baby group were significantly higher than that in little children group.The plasma glucose level at t2 and t3 in Group A were significantly higher than that in Group B.The plasma glucose level at t1 and t2 in Group D were significantly higher than that in Group C.Conclusion The cardiopulmonary bypass has obvious influence on the glucose metabolism in children.The glucose metabolism disorders in cardiopulmonary bypass can make the plasma glucose level increase obviously,and with the CPB time continue,the plasma glucose get higher level.In infants and low weight,the cardiopulmonary bypass has more obvious influence on the glucose,and The younger and lighter infants have the greater fluctuations in blood glucose at all time points.

关 键 词：体外循环 血糖 婴幼儿 心内直视手术 

分 类 号：R726.5[医药卫生—儿科]