心脏外科术后肺部氧摄取的临床观察与分析

目的：通过监测心脏外科需体外循环（CPB）手术的病人术后呼吸功能与动脉血气的变化。了解术后肺部氧摄取的能力。指导心脏外科术后的呼吸治疗。方法：对心脏外科房间隔缺损（ASD）、室间隔缺损（VSD）、风湿性心脏瓣膜病二尖瓣及主动脉瓣置换术后病人42例进行观察。其中肺动脉高压组患者18例,非动脉高压组24例,术后1h吸入氧浓度为50%时测呼吸功能和动脉血气值。结果：术后早期肺部氧摄取功能明显下降。术前合并肺术后1h吸入氧浓度为50%时测呼吸功能和动脉血气值。结果：术后早期肺部氧摄取功能明显下降,术前合并肺动脉高压的患者表现尤其突出。表现为PaO2下降,A-aDO2增大、Shunt%升高。气道阻力增高、静态及动态顺应性下降。结论：心脏外科术后氧摄取能力普遍下降,肺动静脉分流增大,胸肺总的静态顺应性降低,必须加强术后呼吸治疗。

Clinical observation and analysis of pulmonary oxygen absorption in postoperative patients of cardiac surgery

Objective: To understand the function of pulmonary oxygen absorption and guide the postoperative respiratory treatment through monitoring the change of respiratory function and blood gas on cardiac surgery postoperatively. Method: 42 patients with congenital heart disease (atrial sepal and ventricular sepal defects) and rheumatic valvular heart disease were divided into two groups, 18 patients with pulmonary arterial hypertension and 24 patients without pulmonary arterial hypertension. The respiratory function and blood gas analysis were measured under ventilator controlled respiration and inhalation of 50% oxygen atl hour postoperatively. Result: The pulmonary function of oxygen absorption significantly decreased postoperatively in all patients being more remarkable among the patients with pulmonary hypertension. Result also showed PaO-2 A aD-2 and shunts % increased. Airway resistance increased and pulmonary static and dynamic compliance decreased. Conclusion: The pulmonary function of oxygen absorption reduces generally after cardiac surgical operation. Respiratory treatment must be emphasized after operation.