摘要
目的 :研究比较体外循环术后 3种肺功能指标的临床意义。方法 :选择在我院连续行择期体外循环下冠状动脉搭桥手术的 2 4例病人 ,根据体外循环停机后机血处理方式不同分为AT组 (血液回收组 )和非AT组 (非血液回收组 ) ,记录在麻醉诱导后及停机后 1、6、2 4、4 8h的血流动力学和氧合指标 ,并计算比较呼吸指数 (RI)、氧合指数 (OI)和M指数 (PaO2 /PAO2 ) 3种肺功能指标。结果 :体外循环术后心脏指数 (CI)、氧摄取率 (O2ER)、氧利用指数 (DO2 I)和氧消耗指数 (VO2 I)均明显升高 ,而静动脉分流率 (Qs/Qt)呈逐渐降低趋势 ,两组间各指标没有差异。AT组中RI、OI和PaO2 /PAO2 在围手术期没有明显改变 ,而非AT组在停机后出现RI升高、OI和PaO2 /PAO2 降低 ,两组间没有统计学差异。但是非AT组停机 2 4h后RI和PaO2 /PAO2 的变化率与AT组有显著差异 ,改变趋势更明显。RI、OI和PaO2 /PAO2 三者均与Qs/Qt和VO2 I呈显著相关关系。结论 :RI、OI和PaO2 /PAO2 都恰当的反映了体外循环术后肺功能的变化 ,并且个体化的监测其动态变化可能对临床工作更具指导意义。
Objective: To compare the clinic significance of three lung function markers after cardiopulmonary bypass operation. Methods: Twenty four patients who continuously took selective coronary artery bypass grafting (CABG) with cardiopulmonary bypass in our hospital were separated randomly to AT group and non AT group according the different treatments of the residue blood in extracorporeal circulation (ECC) circuit, 12 patients in each group.The data of hemodynamics and oxygenation after anesthesia induction and 1,6,24,48 h after ECC were recorded.Respiratory index (RI), oxygenation index (OI) and M index (P aO 2/P AO 2)were counted and compared at the same time. Results: CI, O 2ER , DO 2I and VO 2I were all elevated obviously after ECC, and Qs/Qt were decreased. There were no difference of all these markers between two groups. RI, OI and P aO 2/P AO 2 did not change during perioperation in AT group, but in non AT group, RI was increased after ECC, company with the decrease of OI and P aO 2/P AO 2 at the same time. Nevertheless there was no difference between two groups. But the alterations of the marker percentages were more obviously, there were marked differences between the percentages of RI and P aO 2/P AO 2 24 h after ECC.All three markers had correlation with Qs/Qt and VO 2I. Conclusion: RI,OI and P aO 2/P AO 2 all can reflect appropriately the change of lung function after extracorporeal circulation and the monitor of the develo pmental alterations individually may be more instructive in clinical practice.
出处
《北京大学学报（医学版）》
CAS
CSCD
北大核心
2003年第2期195-199,共5页
Journal of Peking University:Health Sciences
基金
北京市科委重点项目 (95 2 0 90 10 0 )资助~~
关键词
体外循环
呼吸功能不全
自气/分析
冠状动脉旁路移植术
输血
自体
Extracorporeal circulation
Respiratory insufficiency
Blood gas analysis
Coronary artery bypass grafting
Blood transfusion,autologous
