心内直视手术中酸碱平衡的观察

本文观察了508例心脏疾病患者的1727例次在心内直视手术中的动脉血气。其中，非紫绀型先天性心脏病341例，紫绀型先天性心脏病79例、后天性心脏病88例。发现转流前即有不同程度酸碱失衡存在；转流中由于麻醉、灌注、低温及手术等多种因素进一步加重酸大失衡。以呼吸性碱中毒最常见，代谢性酸中毒次之；停机后有改善。故术中监测酸碱和血气变化，及时处理严重并发症是非常重要的。合适的人工灌注、给予改善微循环药物及适当补碱，对维持酸碱平衡是有利的。

A study on acid-base disorders during cardiac surgery with cardiopulmonary bypass

1727 arterial blood gas samples of 341 cases of acyanotic congenitla heart diseases,79 cases of cyanotic congenital heart diseases and 88 cases of acquired heart diseases during cardio-pulmonary bypass surgery were analyzed.It was found that there were various degrees of acid-base disorders right before the bypass was on.During the speration,acid-base imbalance was aggravated because of anesthesia,fluid infusion,hypothermia,surgical manipulation,etc.Respiratory alkalosis was most common to occur,and metabolic acidosis was the secodn.After the cessation of bypass,acid-base disorders could be significantly alleviated or imporved.So it is belived that it is very important to monitor the changes of blood gases and acid-base balance and to manage timely the complications during cardiopulmonary bypass.Fluid infusion,administration of agents to improve the microcirculation.and replacement of alkaline electrolytes are helpful to maintain acid-base balance.