体外循环下室间隔缺损修补术对小儿血液主要生化指标的影响

目的：分析在体外循环下室间隔缺损修补术过程中小儿血液主要生化指标监测值的变化情况,为临床工作提供参考。方法：回顾性分析我院2008年1月至2010年12月行全身麻醉＋体外循环下室间隔缺损修补术患儿的临床资料,统计体外循环过程中监测值,经SPSS17.0软件进行统计学处理。结果：本组血Na＋无显著变化（P〉0.05）,血K＋在开放升主动脉之后较转机前升高（P〈0.05）,波动幅度均在正常生理范围内。血Ca2＋、Hb和HCT在转机后均下降（P〈0.05）;血Ca2＋开放升主动脉后回升（P〈0.05）,停机后恢复至转机前正常水平（P〉0.05）;Hb和HCT停机后较转机前降低（P〈0.05）。PH在停机后下降（P〈0.05）,波动幅度在正常生理范围内;PCO2、TCO2、HCO3-均在停机后升高（P〈0.05）;Lac和Glu转机至停机后升高（P〈0.05）,Lac波动幅度在正常生理范围内,高Glu指示高血糖。结论：监控血K＋,改善血红蛋白含量和红细胞压积,及时干预血乳酸升高和高血糖,对手术安全顺利进行有重要意义。

The impacts of CPB ventricular septal defect repair to the blood biochemical indicators of children

Objective： To analysis the changes of monitoring values during the CPB ventricular septal defect repair in pediatric patients,and provide reference for clinical work.Methods：Patients＇ clinical information was collected and retrospectively analyzed.All of them had undergone general anesthesia and CPB ventricular septal defect repair during January 2008 to December 2010 in our hospital.The monitoring values on various stages of the surgery were analyzed statistically by SPSS 17.0 software.Results： There was no significant change in blood Na＋（P0.05）,and blood K＋ was increased after declamping aorta（P0.05）,their fluctuations were in the normal physiological ranges.Blood Ca2＋,Hb and HCT were all decreased after the CPB turned（P0.05）.Blood Ca2＋ Was returned to normal level after the CPB（P0.05）.Hb.and HCT were lower than before（P0.05）.PH was decreased after the CPB（P0.05）,while it maintained in the normal physiological range.PCO2,TCO2 and HCO-3 were all increased after the CPB（P0.05）.Lac and Glu were both increased after the CPB turned until it ended（P0.05）.Lac maintained in the normal physiological range.Conclusions： It＇s important to monitor blood K＋,improve Hb and HCT,as well as to deal with hyperlactatemia and hyperglycemia timely during the CPB ventricular septal defect repair.