复方醋酸钠在心肺转流心脏瓣膜置换术中对血乳酸和血糖的影响  

Effects of compound sodium acetate on blood lactate and glucose in patients undergoing cardiac valve replacement with cardiopulmonary bypass

作　　者：戴双波[1] 江国健[1] 林剑兵[1] 齐娟[1] 

机构地区：[1]福建医科大学省立临床医学院福建省立医院麻醉科,福州市350001

出　　处：《临床麻醉学杂志》2011年第9期873-874,共2页Journal of Clinical Anesthesiology

摘　　要：目的观察复方醋酸钠溶液在心肺转流（CPB）心脏瓣膜置换术中对血乳酸（Lac）、血糖（Glu）及血钾（K＋）浓度的影响。方法择期行CPB心脏瓣膜置换术患者40例，随机均分为复方乳酸钠组（R组）和复方醋酸钠组（L组）。于CPB开始前（To）、CPB开始后15min（T1）、升主动脉开放前5min（T2）、CPB结束前5min（L）和关胸后（T4）抽取动脉血或CPB机管路动脉端血液，检测Lac、Glu、K＋浓度。结果L组Lac浓度在T1～T4时均显著低于R组（P〈0．05）；L组Glu浓度仅在T1时点明显高于R组（P〈0．05）；两组各时点血K＋差异无统计学意义。结论心脏瓣膜置换术中，用复方醋酸钠作CPB晶体稀释液可降低术中Lac浓度的升高。Objective To observe the effects of compound sodium acetate on the blood concentrations of lactate, glucose and potassium in cardiac valve replacement surgery with cardiopulmonary bypass （CPB）. Methods Forty patients scheduled for elective cardiac valve replacement surgery were divided randomly into two groups： lactate ringer＇s group （group R） and acetate ringer＇s group （group L）. Blood samples were taken from arteries or artery ends of CPB before start of CPB （T0）, 15 min after start of CPB （T4）, 5 min before aortic unclamping （T2）, 5 rain before termination of CPB （T3） and after sterna closure （T4） to determine the concentrations of lactate, glucose and potassium. Results Compared to group R, the concentrations of lactate in group I. were significantly lower at T1-T4 （P〈0.05）, while the concentrations of glucose were markedly higher at T1 （P〈0.05）. There was no significant difference in the concentrations of potassium between the two groups. Conclusion The concentrations of lactate are significantly lower while using acetate ringer＇s as the crystal dilution for CPB than usinG lactate ringer＇s.

关 键 词：复方醋酸钠 心肺转流 血乳酸 血糖 

分 类 号：R654.2[医药卫生—外科学]