零平衡超滤在体外循环中对血清乳酸和血糖的影响  

Effect of zero-balanced ultrafiltration on serum lactic acid level and glucose level during and after cardiopulmonary bypass

作　　者：常丽[1] 万俊哲[1] 张伟[1] 裴斐[1] 李二田[1] 杜新爱[2] 熊咏民[2] 

机构地区：[1]西安交通大学第二附属医院心血管外科,陕西西安710004 [2]西安交通大学医学院地方病研究所,陕西西安710061

出　　处：《国外医学（医学地理分册）》2013年第3期177-179,共3页Foreign Medical Sciences：Section of Medgeography

摘　　要：目的观察体外循环手术中零平衡超滤对血清乳酸和血糖水平的影响。方法将进行体外循环心内直视手术的患者90例,随机分为两组。实验组采用零平衡超滤技术,对照组不采用任何形式的超滤,采用雷度ABL-77血气分析仪监测两组术后血红蛋白浓度(Hb)、血清乳酸水平(Lac)以及血糖(Glu)水平,并观察术后用血量及术后24 h胸腔引流量。结果超滤组术后血红蛋白浓度明显高于对照组(P<0.05);超滤组术后血清乳酸水平及拔管后的血清乳酸水平明显低于对照组(P<0.05);超滤组术后用血量、24 h胸腔引流量和尿量均明显少于对照组(P<0.05);而两组患者的血糖水平比较无明显差别(P>0.05)。结论应用零平衡超滤,可以有效地减少体外循环后患者体内血清乳酸水平,提高血红蛋白浓度,而对血糖水平无明显影响。Objective To observe the effect of zero-balanced ultrafiltration （ZBUF） on serum lactic acid level and glucose level during and after cardiopulmonary bypass （CPB）. Methods A total of 90 patients undergoing open heart surgery with CPB were randomly divided into two groups according to whether the ZBUF technique was used during CPB. The hemoglobin （Hb）, Lactic （Lac） and Glucose （Glu） were measured by ABL-77 blood-gas ana- lyzer. Blood infusion and thoracic drainage was recorded. Results After the operation, Hb was higher in the ZBUF group than in the control group （P 〈 0.05）, while Lac was lower in the ZBUF group than in the control group （P〈0.05）. Blood infusion, thoracic drainage in 24 hours and urine volume were less in the ZBUF group than in the control group （P〈0.05）. Glu had no statistical difference between the two groups. Conclusions Zero-bal- anced ultrafiltration may significantly decrease lactic acid and improve the hemoglobin concentration after CPB, but may not decrease blood glucose level.

关 键 词：零平衡超滤 体外循环 血清乳酸 血糖 

分 类 号：R743[医药卫生—神经病学与精神病学]