动脉血乳酸对心脏术后患者的病情评估作用.doc

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1、--文章编号:动脉血乳酸对心脏术后患者的病情评估作用王显悦通讯作者：王显悦.Tel:(020)36654575　Email:nnndhotmail.作者简介：王显悦.硕士,主治医师.卫达王晓武马涛梅鲁刚梁爱琼琰（军区总医院心脏外科中心，510010）PathogeneticconditionevaluationeffectofarterialbloodlacticacidonpostcardiotomypatientsWANGXian-yue，ZHANGWei-da，WANGXiao-wu，MAT

2、ao，MEILu-gang，LIANGAi-qiong，ZHANGYanDepartmentofCardiovascularSurgery,theMilitaryGeneralHospitalofGuangzhoumand,GuangzhouGuangdong510010,ChinaCorrespondingauthor:WANGXian-yue【Abstract】Objective：Toidentifythepathogeneticconditionevaluationeffectofarter

3、ialbloodlacticacidonpostcardiotomypatients.　METHODS：62postcardiotomypatientsweredividedintotwogroupsaccordingtoarterialbloodlacticacidvalues.Thevalueof2.0mmol/LatICUadmissionwaschosenasthesectionpointforarterialbloodlacticacid.Thepatientswiththemeanva

4、lueoflessthan2.0mmol/L(groupA)wereparedwiththeremainingpatients(groupB)onlengthofICUstay,ventilationtimeandfrequencyofvasoactiveagentandalkalinedruguse.Therecoveryofpatientsandvariationtendencyofarterialbloodlacticacid,PHandBEwererecordedfromtwogroups

5、.　RESULTS：IngroupA,therewasonecasetowhichleftpulmonaryatelectasisoccurred.OnepatientdiedoflowoutputsyndromeingroupB.paredwithgroupA,groupBhadlongerventilationtimeandthelengthofICUstay(P<0.05),andhigherfrequencyofvasoactiveagentandalkalinedruguse(P<0.0

6、5).GroupBhadagreaterfluctuationonthevalueofpostoperativearterialbloodlacticacid,PHandBE.Thesevaluesfluctuatedmost5hoursafteroperationandregressedgraduallybacktothenormal15-20hoursafteroperation.CONCLUSION：ThevalueofArterialbloodlacticacidcanbeusedtoev

7、aluatepathogeneticconditionofpostcardiotomypatientstoacertainextent.Patientswithhighlevelofarterialbloodlacticacidhaveanunstablepathogeneticconditioninearlierpostoperation.Theyneedmoredrugstomaintainvitalsignandhomeostasisandhavealongerpostoperativere

8、covery.【Keywords】Lacticacid；postcardiotomy；pathogeneticconditionevaluation【摘要】　目的：明确动脉血乳酸对于心脏术后患者的病情评估作用。方法：随机抽取62--可修编----例心脏术后患者，选择入监护室即时动脉血乳酸低于2.0mmol/L的30例患者分为A组，余32例为B组。比较两组患者呼吸机辅助时间、监护室滞留时间以及血管活性药物和碱性药物使用情况。观察两组患者术后恢复情况和动脉血乳酸、酸碱度和碱剩余的变化趋