体外循环手术病人胰腺内、外分泌功能的变化

目的：观察体外循环手术病人围期胰腺内，外分泌功能的变化以及影响这些变化的可能因素。方法：20例体外循环病人分别测定术前，术后2，24，48h血糖，淀粉酶，胰岛素，C肽浓度。结果：血糖，胰岛素，C肽含量，术后与术前经均有明显提高（P＜0．05）；术中，术后2h血淀粉酶的值与术前比较无明显差异（P＞0．05），但手术后24，48h即显高于术水平（P＜0．05）。淀粉循环围术期胰腺内，外分泌功能均存在着不同程度的损害，而避免体外循环转流中灌注压过低对减轻胰腺功能的损害具有一定积极意义，术后早期应避免输入高渗葡萄糖。

Changes in Pancreatic Endocrine and Exocrine Function in Patients Undergoing Cardiopulmonary Bypass

Objective: To study the changes in pancreatic endocrine and exocrine function in patients undergoing cardiopulmonary bypass (CPB) and the factors affecting such changes. Clinical material and method: Twenty patients undergoing open heart surgery with CPB were studied.Blood samples were drawn preoperatively,and 2,24 and 48 hours postoperatively for assessing serum glucose,insulin,c_peptide and amylase. Result: There was significant increase in levels of serum glucose,insulin and c_peptide after CPB,comparing to their baseline levels. The levels of serum amylase during CPB and 2 hours postoperatively were not higher than those preoperatively,but they were markedly elevated after 24 and 48 hours of operation. Correlative analysis showed that there was a negative relation between serum amylase and mean perfusion pressure (MPP),so was between c_peptide and MMP(P<0.05). Conclusions: The damage of pancreatic endocrine and exocrine function is closely related to CPB. Avoiding too low perfusion pressure is beneficial to protect pancreatic endocrine and exocrine function during CPB. Infusion of hypertonic glucose in early postoperative stage is avoided as well.