绵羊在膜肺治疗前后的电解质和酸碱平衡的改变  

The changes of electrodes and acid-base balances during and post extracorporeal cardiopulmonary membrane in sheep

作　　者：甘小庄[1] 宋国维[1] 黄伟雄[1] 李杰[1] 李惠[1] 孙丽萍[1] 马广松[1] 洪京[1] 

机构地区：[1]首都儿科研究所,北京100020

出　　处：《实用儿科临床杂志》2003年第4期258-260,共3页Journal of Applied Clinical Pediatrics

摘　　要：目的　观察绵羊在膜肺治疗前后电解质、酸碱平衡的改变。方法　绵羊 11只 ,体重 2 2± 5kg ,戊巴比妥麻醉后 ,气管切开 ,插管 ,与呼吸机相连。右颈内静脉和右颈总动脉内放置导管。血从右颈内静脉引出 ,经过膜氧合器气体交换后 ,从右颈总动脉回输体内。分别在膜肺治疗前 ,治疗 1、2、3h ,治疗后 1d、1周和 2周测定绵羊的血生化、血气分析。结果　血钾、血钙治疗中显著下降 ,治疗后 1d恢复正常 ;其他电解质、血糖、尿素氮和肌酐等在治疗中虽有改变 ,但均在正常范围。PaO2 和BE治疗前后无显著改变 ,pH在治疗后 1h和 1d时升高 ,PaCO2 下降 ,差异有显著性。结论　正常绵羊在膜肺治疗中血钾、血钙降低 ;pH在治疗后 1h和 1d升高 ,PaCO2同时下降 ,差异有显著性 ,治疗后 3d恢复正常 ,提示治疗前后要严密监测 ,及时治疗 ,维持电解质和酸碱平衡。Objective We observed the changes of electrodes and acid base balances pre extracorporeal cardiopulmonary membrane (ECMO), during and post ECMO in sheep .Methods Eleven Sheep , weights 22±5 kg , were anesthetized with pentobarbital, tracheostomized and mechanically ventilated and catheterized. Blood was siphoned from the right internal jugular venous cannula and returned to the animals by the right carotid artery cannula after oxygenation. The blood biochemistry and gas analysis were assessed pre ECMO, at 1, 2, 3 hours during ECMO and 1day, 1 week and 2 weeks post ECMO.Results The blood potassium and calcium reduced significantly below normal values during ECMO and recovered to normal scope 1 day post ECMO; other values of electrodes, glucose, BUN and Crea had some changes, but within normal scope. There were no differences in PaO 2 and base excess pre ECMO, during and post ECMO. Higher pH and lower PaCO 2 were showed significantly 1h during ECMO and 1day post ECMO.Conclusions Lower blood potassium and calcium were showed in normal sheep during ECMO. Higher pH and lower PaCO 2 were showed during ECMO and lasted until 1 day post ECMO; They recovered 2 days post ECMO. It indicated that the balances of electrodes and acid base should be kept during and post ECMO under careful monitoring and treatment in time

关 键 词：膜肺 治疗 电解质 酸碱平衡 绵羊 血生化 血气分析 戊巴比妥 麻醉 

分 类 号：R563.8[医药卫生—呼吸系统]