深低温停循环主动脉外科术后严重低磷血症的研究  

The clinical study of significant hypophosphatemia following aortic surgery with deep hypothermic circulatory arrest

作　　者：焦若男[1] 杜雨[1] 吴慧[1] 刘红[1] 曹芳芳[1] 张海涛[1] 

机构地区：[1]北京协和医学院中国医学科学院国家心血管病中心阜外心血管病医院心血管疾病国家重点实验室,北京100037

出　　处：《中国体外循环杂志》2013年第2期89-91,78,共4页Chinese Journal of Extracorporeal Circulation

摘　　要：目的研究主动脉外科术后严重低磷血症发生率及其对患者预后的影响。方法回顾性分析2011年1月～2012年8月深低温停循环主动脉手术病历资料178例,收集患者术前、术中、术后变量,包括术后两天血磷浓度、机械通气时间、ICU时间等。根据手术后第一天血磷浓度是否≤0.48 mmol/L分为严重低血磷组及对照组。对两组术前、术中、术后变量做统计学分析。结果急诊患者出现严重低血磷概率较高;严重低磷血症患者比对照组患者术后24 h内使用的血管活性药物种类多,氧合指数低。结论严重低磷血症是主动脉手术后常见并发症,且与术后氧合指数和血管活性药使用剂量相关,建议对心脏术后患者常规检测血磷水平。对术后严重低磷血症的干预治疗及疗效需做进一步研究。Objective To investigate the prevalence of hypophosphatemia after aortic surgery, and its clinical influence. Methods Between January 2011 and August 2012, 178 patients underwent aortic arch replacement with deep hypothermic circulatory arrest were retrospectively analyzed. Patients were divided into two groups according to the serum phosphate （SH） level measured in the first day after surgery： low SH group （SH≤0.48 mmol/L） , and control group. Preoperative, intraoperative and postoperative data of the two groups, including duration of bypass, duration of ventilation and duration of ICU were collected and analysed. Results E- mergency patients showed more significant hypophosphatemia. Compared with in the control group, patients in the SH group required more cardioactive drugs and appeared lower oxygenation index in the first postoperative day. Conclusion We have shown that hy- pophosphatemia is common after aortic surgery and is associated with postoperative cardioactive drugs dosage and oxygenation index. We suggest that phosphate levels should be routinely measured after surgery. Appropriate replacement therapy should be developed.

关 键 词：低磷血症 主动脉手术 深低温停循环 

分 类 号：R654.2[医药卫生—外科学]