猪背驮式肝移植术中血清电解质的变化及其处理

Changes and management of plasma electrolytes during piggy-back orthotopic liver transplantation in pigs

目的 了解猪背驮式肝移植实验中电解质的变化 ,并探讨处理措施。方法 对猪施行背驮式肝移植 ,在恢复门静脉血流前 10min快速静脉滴注 5 0g/L碳酸氢钠 2ml/kg ,测定麻醉后、无肝期、无肝期结束、门静脉开放新肝期开始后的外周静脉血以及门静脉开放即刻时门静脉血电解质浓度。结果 门静脉开放后外周血钾离子浓度呈进行性上升 ,门静脉血钾离子浓度明显较外周血钾离子浓度高 (P <0 .0 1) ;门静脉开放前给予碳酸氢钠静脉滴注可以明显降低外周血和门静脉血钾离子浓度 (P <0 .0 1)。

Objectives To investigate the changes of electrolytes during piggy-back orthotopic liver transplantation (PBOLT) in pigs and make out some management.Methods Plasma and portal vein blood samples were taken from 8 health selected pigs under anesthesia to analyze the concentrations of electrolytes. Some pigs were transfused with 5% sodium bicarbonate (2?ml/kg).Results After portal vein was reopened, the plasma potassium concentration was increased gradually.Compared with that of plasma, the potassium concentration of portal vein was increased significantly (P< 0.01). A dramatic decrease of plasma and portal vein potassium concentration could be observed when sodium bicarbonate was transfused before reperfusion (P< 0.01).Conclusion Intravenous injection of adequate sodium bicarbonate before portal vein opening can lower the transient elevation of plasma potassium concentration after portal vein opening.