硝普钠对心脏瓣膜置换术后早期氧代谢的影响  

Effects of sodium nitroprusside on oxygen metabolism in patients undervent cardiac valve replacement

作　　者：刘流[1] 周建美[1] 陈启智[1] 吕志平[1] 曹丽君[1] 

机构地区：[1]中南大学湘雅二医院麻醉科,长沙市410011

出　　处：《临床麻醉学杂志》2004年第2期84-86,共3页Journal of Clinical Anesthesiology

摘　　要：目的　观察硝普钠对心脏瓣膜置换术后早期氧供需平衡的影响。方法　 2 4例心脏瓣膜置换术病人随机分为硝普钠组 (A组 )和对照组 (B组 ) ,每组 12例。A组病人在心肺转流 (CPB)复温时用硝普钠 1 0 μg·kg 1·min 1输注。停CPB后改为 0 8～ 4 6 μg·kg 1·min 1输注。观察两组病人氧供、氧耗、氧摄取率、混合静脉血氧饱和度、动脉血乳酸和心指数的变化。结果　停CPB后两组病人氧供 ,心指数同时点值比较无显著差异 (P >0 0 5 ) ;停CPB后 1、2h时A组病人氧耗、氧摄取率明显高于B组病人同时点值 (P <0 0 5 ) ,动脉血乳酸明显低于B组病人 (P <0 0 5 ) ,且A组病人呈病理性氧供依赖持续时间短于B组病人。Objective To study the effects of sodium nitroprusside (SNP on the balance of oxygen delivery and consumption in patients undervent cardiac valve replacement. Methods Twenty four patients undervent cardiac valve replacement were randomly divided into group SNP (group A,n=12) and control (group B,n=12). SNP was given at a rate of 1.0 μg·kg -1·min -1 during rewarming,and of 0.8-4.6 μg·kg -1·min -1 after cardiopulmonary bypass (CPB) in group A. The changes of oxygen delivery (DO 2),oxygen consumption (O 2),oxygen extract ratio (ERO 2),cardiac index (CI) and arterial blood lactate (ABL) were observed. Results DO 2 and CI were not significantly different between two groups after CPB (P>0.05).O 2 and ERO 2 were higher while ABL was lower in group A than those in group B at 1,2 h after CPB. In group A,pathologic DO 2 dependence O 2 existed shorterr than that in group B. Conclusion The disturbance of oxygen metabolism early after CPB may be improved by giving SNP with positive inotropic agent therapy.

关 键 词：硝普钠 心脏瓣膜置换术 氧代谢 心肺转流 CPB 

分 类 号：R614[医药卫生—麻醉学]