血乳酸水平对体外循环手术预后评估的价值  

The value of the level of blood lactic acid in the determination of prognosis in cardiac pulmonary bypass

作　　者：翟红燕[1] 王惠芬[2] 李长健[2] 刘小琳[2] 

机构地区：[1]天津胸科医院肺功能科,天津300051 [2]天津胸科医院,300051

出　　处：《中国心血管杂志》2001年第3期139-141,共3页Chinese Journal of Cardiovascular Medicine

摘　　要：目的 评价血乳酸水平对心脏外科体外循环手术预后的判断价值。方法 分析28例心脏外科手术患者体外循环转终、术后5小时、术后2天的血气、乳酸测定结果及血乳酸水平与手术预后的关系。结果 手术转终时治愈组和死亡组血乳酸水平分别为6.54±2.91mmol/L和8.79±4.26mmol/L;术后5小时治愈组降至4.33±3.09mmol/L,死亡组上升至8.93±4.01mmol/L,两组差异显著(P<O.05);术后2天,治愈组下降至2.42±1.43mmol/L,而死亡组则继续上升至9.29±4.74mmol/L,两组差异非常显著(P<O.01)。结论 患者术后血乳酸值的变化与预后有密切关系,术后血乳酸值持续增高,其预后极差。血乳酸水平可作为心脏外科手术患者预后评估的一项理想的、直观的监测指标。Objective To assess the value of blood lactic acid(LA) in the determination of prognosis after cardiac pulmonary bypass(CPB). Methods The results of blood LA and blood gas at the end of CPB, 5 hours and 2 days after operation in 28 cardiac operative patients were analysed. The relationship between blood LA and the prognosis of operation was studied. Results At the end of operation, the level of blood LA of curative group and dead group was 6. 54±2. 91mmol/L and 8. 79±4. 26mmol/L respectively. At 5 hours after operation, the former descended to 4. 33±3. 09mmol/L,the later ascended to 8. 93±4. 01mmol/L. there was a significant difference between two groups (P<0. 05). At 2 days after operation ,the level of blood LA of curative group descended to 2. 42±1. 43mmol/L,while the level of dead group continued to ascend and reached 9. 29±4. 74mmol/L, there was a very significant difference between two groups (P<0. 01). Conclusion The alteration of blood LA concentration was closely related to the prognosis in postoperative patients. The blood LA in postoperative patients increased persistently and their prognosis were much more worse. The level of blood LA is reguarded as an ideal and visualized monitoring parameter for the assessment of prognosis in cardiac operative patients.

关 键 词：血乳酸 体外循环 血气分析 预后 

分 类 号：R654.2[医药卫生—外科学]