体外循环心脏直视手术术后血清钠离子浓度的变化

目的分析体外循环心脏直视手术患者术后血清中钠离子的含量变化。方法选取2008年8月至2010年8月在我院及重庆医科大学附属第一医院就诊行体外循环心脏直视手术的82例患者,检测这些患者术后血清中钠离子浓度,并分析导致钠离子含量变化的原因。结果术后有50例患者出现低钠血症（血清中钠离子的含量小于135mmol/L）,低钠血症的发生率为61.1%（50/82）,其中7例患者的低钠血症持续1～3d,30例患者的低钠血症持续4～9d,余13例患者的低钠血症的持续时间超过9d。主动脉阻断时间与术后低钠血症的发生率正相关,术后多巴胺和硝普钠的给药时间与低钠血症的发生率负相关。结论低钠血症的出现可能与手术创伤、手术对机体内分泌的刺激和体外循环有关。行体外循环心脏直视手术患者术后出现低钠血症的几率较高,纠正低钠血症有利于患者的术后恢复,临床上应注意纠正术后低钠血症。

Concentration of serum sodium ion after extracorporeal circulation in open heart surgery

Objective To detect the concentration of serum sodium ion after extracorporeal circulation in open heart surgery.Methods 82 patients who underwent extracorporeal circulation in open heart surgery from Aug,2008 to Aug,2010,and the concentration of serum sodium ion after surgery was detected.Results 50 patients had hyponatremia after surgery,and the incidence of hyponatremia was 61.1%（50/82）.7 of 50 patients had hyponatremia less than 3 days;30 of 50 patients had hyponatremia for 4 to 9 days;while the rest 13 patients had hyponatremia more than 9 days.The time length of aortic occlusion is positive correlated to hyponatremia,while the time length of dopamine and sodium nitroprusside using is negative correlated to hyponatremia.Conclusion Hyponatremia may be related to trauma of surgery,stimuli of hormonal system after surgery and extracorporeal circulation.The incidence of hyponatremia after extracorporeal circulation in open heart surgery is higher,and hence more attention should be paid to correcting hyponatremia in order to prompt the recovery after extracorporeal circulation in open heart surgery.