两种晶体预充液对体外循环下心脏瓣膜置换手术患者术后乳酸水平的影响

The effect of two kinds of crystals priming on the lactate level of patients undergoing heart valve replacement under cardiopulmonary bypass

目的:探讨两种晶体预充液对体外循环下行心脏瓣膜置换手术患者术后乳酸水平的影响。方法:2014年1月-2018年4月收治在体外循环下行心内直视心脏瓣膜置换手术治疗的患者60例,随机分为两组,各30例。A组采用醋酸钠林格注射液,B组采用乳酸钠林格注射液。两组分别于体外转机前(T0)、体外停机后(T1)、术后1 d(T2)、术后2 d(T3)、术后3 d(T4)取动脉血,检测血清乳酸水平。结果:与T0时间比较,两种预充液对患者T1和T2时间血清乳酸水平增高均有影响,A组T3时间血清乳酸水平远低于B组,差异有统计学意义(P<0.05)。结论:醋酸钠林格注射液作为体外循环晶体预充液,与乳酸钠林格注射液相比,能降低术后血清乳酸水平,加快患者康复。

Objective:To investigate the effect of two kinds of crystals priming on the lactate level of patients undergoing heart valve replacement under cardiopulmonary bypass.Methods:From January 2014 to April 2018,60 adult patients who underwent open heart valve replacement under cardiopulmonary bypass were treated,they were randomly divided into the two groups with 30 cases in each group.The group A was treated with sodium acetate ringer injection.The group B with sodium lactate ringer injection.The blood samples were taken before external transfer(T0),after external shutdown(T1),1 day after operation(T2),2 days after operation(T3)and 3 days after operation(T4)to detect the serum lactate level.Results:Compared with T0,the two kinds of crystals priming had an effect on the increase of T1 and T2.T3 in the group A was much lower than that in the group B,the differences were statistically significant(P<0.05).Conclusion:Compared with sodium lactate ringer injection,sodium acetate ringer injection can reduce the serum lactate level and accelerate the recovery of patients.