α稳态法应用于体外循环中的意义

Randomized study αstat management during hypothermic cardiopulmonary bypass

目的观察比较α稳态法和ｐＨ稳态法测定体外循环中低温和复温时的血气结果，评价α稳态法应用于体外循环中的意义。方法随机选择７例先天性心脏病（室间隔缺损或房间隔缺损）患者，分别于术前、低温２８℃时、复温至３１℃和３６℃时采取动静脉血样，采用α稳态法和ｐＨ稳态法进行血气分析。结果在低温２８℃和３１℃时用α稳态法处理的动静脉血样本与ｐＨ稳态法处理的样本结果有显著性差别，表现酸血症和高碳酸血症。结论低温体外循环中α稳态法可以反映出低温和复温时的酸血症和高碳酸血症，维持α稳态更有利于大脑灌注的调节。

Objective To compare the values of αstat with pHstat strategy used in hypothermic cardiopulmonary bypass (CPB). Methods Seven patients undergoing cardic surgery were studied. Both arterial and venous blood samples were analyzed for bloodgas at preoperation, hypothermic 28℃, rewarming 31℃, 36℃. Respectively by αstat and pHstat. Results PCO2 in the αstat strategy was significantly higher than that in the pHstat strategy at 28℃, rewarming 31℃, respectively, which were hypercarbia. In the αstat strategy, pH was significantly different from that in the pHstat strategy during hypothermia and rewarming (P<005, respectively). Conclusion αstat strategy is more appropriate to acidbase of management during hypothermic CPB.