体外循环心内直视手术围术期血浆与红细胞内钾改变的研究

Study on changes of potassium in plasma and red cells during period of extracorpeal circulation.

目的 研究体外循环心内直视手术围术期 (包括手术前、转流前、停机、术毕、术后 2 4h、术后 48h)血浆及红细胞内钾的变化及其影响因素。方法 选取低温体外循环下行心内直视手术的心脏病人 118例。根据沈路一法稍加改良 ,测定血浆钾、红细胞内K+浓度。结果 从转流开始至转流中血清钾降低 ,与术前比较P <0 0 5 ,而红细胞内钾明显升高一直持续到术后 2 4h恢复正常 ,与术前比P <0 0 5。结论 体外循环心脏手术转流过程中发生低血钾 ,主要原因是钾向细胞内转移所致 ,而钾内转移受低温、皮质醇升高、糖原及胰岛素升高以及激活交感—儿茶酚胺系统的影响。

To study changes and mechanism of potassium distribution in plasma and red cells during perioperation of extracorporeal circulation.Methods 118 patients during operation,using improved Shen Luyi methods and inductance coupling plasms emission spectroscopy and atomic absorption spectroscopy,to analyz the concentration changes of k + in plasma and red cells.Results K + in serum were decreased from the initial stage of circulation to the passing of circulation,K + in red cells were significantly increased from the passing of circulation to 24 hours after operation.Conclusion The stress reaction make potassium to enter the cells, K + in blood decreases during hypothermia extracorporeal circulation.