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目的 :探讨小儿和成人血浆总钙和离子钙在心肺转流术中的变化规律。方法 :择期心肺转流术 (CPB)下心内直视手术患者 ,成人 2 6例 ,小儿 2 4例。分别于CPB前、中及补钙前、后 5min抽取血标本测定离子钙和血浆总钙含量。结果 :CPB中成人血浆总钙较CPB前有所下降 ,但差异无显著性 (P >0 .0 5 ) ,而离子钙下降不明显 (P >0 .0 5 )。小儿血浆总钙下降不明显 (P>0 .0 5 ) ,而离子钙下降明显 (P <0 .0 1)。结论 :成人和小儿在CPB中有不同的钙代谢变化 ;心跳恢复平稳后 ,适当补钙可改善血流动力学 ;小儿CPB中应加强离子钙的监测 ,以补给葡萄糖酸钙较为合适。
Objective: To investigate the changes of plasma calcium and ionized calcium in children and adults during cardiopulmonary bypass. Methods: Elective cardiopulmonary bypass (CPB) under open heart surgery in patients with open surgery, 26 cases of adults, 24 cases of children. Blood samples were collected before and during CPB, and before and after calcium supplementation to determine ionized calcium and total plasma calcium. Results: The total plasma calcium in adult CPB was lower than that before CPB, but the difference was not significant (P> 0.05), but the decrease of ionized calcium was not significant (P> 0.05). The total plasma calcium in children showed no significant decrease (P> 0.05), while the level of ionized calcium decreased significantly (P <0.01). CONCLUSIONS: Adult and pediatric patients have different changes in calcium metabolism in CPB. After a stable heartbeat recovery, adequate calcium supplementation may improve hemodynamics. Monitoring of calcium ion in children with CPB should be strengthened to make calcium gluconate more appropriate.