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目的通过体外循环(CPB)期间乳酸的变化,探明CPB期间紫绀型与非紫绀型先天性心脏病组织氧代谢的状况。方法将6~10岁先心病患儿20例随机分为两组:A组为非紫绀组,B组为紫绀组。两组分别于手术开始前、CPB前1~3 s、CPB30 s、复温34℃、CPB停止后1~3 s、术毕,6个时点取动、静脉血测血红蛋白(Hb)及动脉乳酸值。结果CPB开始后乳酸值开始升高,复温时乳酸达峰值,以后渐渐回落。转流30 s、复温34℃、停机,术毕的乳酸值与手术开始前相对比均有统计学意义(P<0.05)。结论CPB期间机体存在着组织摄氧能力下降,应改善微循环,给予充足的氧供。
OBJECTIVE: To determine the status of oxygen metabolism in cyanotic and non-cyanotic congenital heart disease (CPB) patients during CPB by the changes of lactate during cardiopulmonary bypass (CPB). Methods 20 children aged 6-10 years with congenital heart disease were randomly divided into two groups: group A was non-cyanotic group, group B was cyanotic group. The two groups were taken before operation, 1 ~ 3 s before CPB, 30 s after CPB, 34 ℃ rewarming, 1 ~ 3 s after CPB stopped, and 6 h after operation. The hemoglobin (Hb) Lactic acid value. Results After the start of CPB, the lactic acid value began to rise, and the lactic acid peaked after rewarming, then gradually decreased. After 30 s of reflow and rewarming at 34 ℃, the lactic acid value at the end of operation was significantly lower than that before operation (P <0.05). Conclusion During the period of CPB, there is a decrease in tissue oxygen uptake in the body. Microcirculation should be improved to provide adequate oxygen supply.