摘要
观察３０例冠状动脉旁路移植术（ＣＡＢＧ）后氧输送指数（ＤＯ２Ｉ）、氧耗指数（ＶＯ２Ｉ）及其关系。其中单纯ＣＡＢＧ１５例，伴左室室壁瘤切除１２例，心脏瓣膜替换３例。全组架１～４支桥者分别是１０、８、８、４例。结果２９例成活，１例死亡。成活组术后即刻至３小时ＤＯ２Ｉ提高１０．６％（Ｐ＜０．０５）。ＶＯ２Ｉ增高１５．８％（Ｐ＜０．０１）．术后１４小时较６小时ＤＯ２Ｉ增加１５．８％（Ｐ＜０．０１），而ＶＯ２Ｉ降低４．４％。死亡例即刻至３小时ＤＯ２Ｉ增加６．０％，ＶＯ２Ｉ却降低２９．１％，死于多器官功能衰竭。资料表明，作为ＣＡＢＧ术后正常恢复经过，早期ＤＯ２Ｉ升高的同时ＶＯ２Ｉ也升高，此时，细胞内氧化磷酸化得到改善，氧债得到清偿。氧输送和氧耗达到平衡后ＶＯ２Ｉ不再增加。可见ＣＡＢＧ术后维持满意ＤＯ２Ｉ非常重要。
O2 transport index(DO2I) , O2 consumption index(VO2I), and the relationship between the two during early postoperative period were observed in 30 patients of coronary artery bypass grafting(CABG). Among the 30 patients, 15 had CABG, 12 had CABG and resection of ventricular aneurysm, and 3 had CABG and aortic valve replacement. 10, 8, 8 and 4 patients had 1 , 2, 3 and 4 coronary arteries grafted, respectively.29 patients recovered from CABG and 1 died(3.3%).In all of the survivors, DO2I increased by 10. 6%(p<0.05) and VO2I increased by 15. 8% at 3 hours, compared to immediately after surgery. DO2I increased by 15. 8% from 6 hours to 14 hours after surgery, but VO2I decreased by 4.4% during the same period. In one patient, DO2I increased by 6. 0%, but VO2I decreased by 29.1% from the end of surgery to 3 hours after surgery and the patient died of multiple organ failure(MOF). Our data suggest that as a normal recovery after CABG, VO2I increases with increasing DO2I during the early postoperative period indicating the correction of O2 delivery and consumption, and thence VO2I no longer increases with increasing DO2I.Therefore, to maintain a satisfactory VO2I is very important for CABG patients in the ICU.
出处
《中国循环杂志》
CSCD
1995年第4期212-214,共3页
Chinese Circulation Journal
关键词
冠状动脉重建术
手术症
氧输送
氧耗
Coronary artery bypass grafting
O_2 transport
O_2 consumption
