紫绀型与非紫绀型先心病术中乳酸的变化

Chance Of Lactate During Cardiopulmonary Bypass Operation Of Non-Cyanosis Congenital Disease And Cyanosis Congenital Disease

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1～3s、CPB30s、复温34℃、CPB停止后1～3s、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30s、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 explore the tissue oxygen metabolism during cardiopulmonary bypass operation of children , through the chance of plasma lactate. Methods Twenty children with congenital disease, below 6 ～ 10years, were assigned into tow-groups. Non-cyanosis congenital disease was infused to A group. Cyanotic congenital disease was infused to B group. Arterial blood lactate lever were measured before operation, before CPB, after CPB30＇ ewarming 34℃, after CPB1～3＇ and finishing operation. Results After CPB, the plasma lactate level of both groups increased gradually, was the highest in rewarming 34℃, then slowly reduced. The change of lactate was significant higher in CPB30＇（P 〈 0.01 ）, in rewarming34℃, after CPB（ 1 ～3 s） and in finishing operation than before operation and before CPB （P 〈 0.05）. Conclusion The increase of the level of plasma lactate during CPB indicated decrease of tissue intaking oxygen; It was necessary that there was full oxygen supply during CPB.