婴幼儿法鲁氏四联症术后氧代谢特点的初步分析 |
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引用本文: | 陈焱,张辉,程沛,李玲,吴永涛,刘承虎.婴幼儿法鲁氏四联症术后氧代谢特点的初步分析[J].中国现代医药杂志,2012,14(3):1-3. |
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作者姓名: | 陈焱 张辉 程沛 李玲 吴永涛 刘承虎 |
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作者单位: | 首都医科大学附属北京安贞医院小儿心脏中心,北京,100029 |
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摘 要: | 目的探讨婴幼儿法鲁氏四联症术后早期氧代谢动力学的变化特点。方法应用4F Swan-Ganz四腔漂浮导管及PHLIPSM:7008A监护仪,总结分析我院2002年1月~2006年5月23例婴幼儿期法鲁氏四联症术后72h内氧代谢动力学的变化特点。结果①术后72h内氧供指数(DO2I)与氧耗指数(VO2I)始终表现为直线相关关系,P<0.05;②术后4~8hVO2I最高,同时氧摄取率(ERO2)明显增加,而DO2I并未显著增加;③心排指数(CI)术后8~12h降至最低,为围手术期72h最低谷,并伴有乳酸(LAC)升高。④术后8~12h内LAC升高,动静脉血氧含量差(Ca-vO2)增加,混合静脉血氧饱和度(SvO2)降低。结论婴幼儿期法鲁氏四联症患者术后存在病理性氧供依赖,易出现组织缺氧,应及时纠正氧代谢失衡,改善组织供氧。
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关 键 词: | 先心病 婴幼儿 法鲁氏四联症 氧供 氧耗 |
Preliminary analysis of oxygen metabolize in tetralogy of fallot after open heart surgery |
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Institution: | Chen Yan,Zhang Hui,Cheng Pei,et al.Department of pediatric cardiology,Beijing Anzhen Hospital,Affiliated of Capital Medical University,Beijing 100029 |
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Abstract: | Objective To determine the rule of oxygen metabolize in tetralogy of fallot(TOF)congenital heart disease after open heart surgery.Methods Using 4F Swan-Ganz pulmonary catheter and PHLIPS M:7008A monitor to analyse the variety of oxygen metabolic indexes during the 72 hours of post-operation.Results ①There was an obvious beeline relation between the DO2 I and VO2I during the 72 hours after open heart surgery(P<0.05).②In the first 4 hours the VO2I was highest,as well as the ERO2,but DO2I didn’t display significant increasing.③CI was more lower during the 8~12 hours than before,and it was the lowest point in the whole period of post-operation,but the LAC shows more higher.④CI was lower during the early 12hours than the others,although it remained in the normol range.But the oxygen indexes changed at the same time,it showed the increasing in LAC,Ca-vO2 and the decreasing in SvO2.Conclusion Pathological dependence on oxygen was existent in postoperative of TOF during childhood.Prone to hypoxia,should rectify the oxygen metabolism imbalances and improve tissue for oxygen. |
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Keywords: | Congenital heart disease Infant Tetralogy of fallot Oxygen delivery Oxygen consumption |
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