心内直视术1490例次血气检测结果临床分析

Clinical evaluation of 1490 arterial blood gas samples during and after open-heart surgery

目的正确评价心内直视术中机体代谢变化的特点。方法对２２５例心内直视术１４９０例次血气检测结果进行分析。结果ＰＯ_（２）１３．３ＫＰａ的占６８．１％，ＰＣＯ_（２）在正常范围的占７２．４％；ｐＨ值正常范围和硷质血症分别占４２．３％和４９．２％，实际碳酸氢盐和剩余硷高于正常的分别占４８．５％和５９．９％电解质多在正常范围。结论正确使用呼吸机，合理进行氧治疗，及时发现、处理并发症：酌情应用碳酸氢钠，及时补充血容量和钾离子，减少术后早期硷质血症的发生，以提高手术疗效。

Objective To evaluate the changes of body metabolism during and after open-heart surgery, Method 1490 arterial blood gas samples of 225 cases were measured during and after open-heart surgery. Result of the 1490 arterial blood gas samples, 68. 1 % showed oxygen tension with PO_2 more than 13.3 kPa., 72.4% carbon dioxide tension with PO_2 was between 3.99 kPa and 6.65 kPa, 42.3% had normal pH value and 49.2% increase pH. Actual bicarbonate in 48.5% samples and base excess in 59.9% were higher than normal level. Electrolyte consistency in most samples remained normal range, Conclusion These measures, such as using respirator. reasonable application of oxygen concentration, timely management of postoperstive complications, are important postoperatively. In order to reduce the alkalemia during the early postoperative period, we may consider the administration NaHCO3 during open-heart surgery. Meanwhile we need to pay attention to transfusion and supply of potassium to reduce sodiumion absorbed through kidney.