低月龄、低体质量体外循环患儿乳酸水平与血糖及氧合指标的相关性

目的:分析因先天性心脏病行体外循环治疗的低月龄、低体质量患儿其体内乳酸水平与血糖及氧合指标的相关性。方法:选择在体外循环下行手术治疗的小儿先天性心脏病病人129例,根据术后6 h乳酸水平,将患儿分为高乳酸组(n=43)和正常乳酸组(n=85)。比较2组患儿手术相关指标及体内葡萄糖、乳酸和氧合指标水平。采用多因素logistic回归模型分析影响患儿术后体内乳酸水平的因素,应用Pearson相关模型对术后6 h患儿体内乳酸水平与葡萄糖及氧合指标的相关性进行分析。结果:高乳酸组患儿体外循环时间、主动脉阻断时间、葡萄糖及乳酸水平均高于正常乳酸组(P<0.05～P<0.01),2组动脉血氧饱和度(SaO₂)与静脉血氧饱和度(SvO₂)差值(SaO₂-SvO₂)水平、酮症发生率差异均无统计学意义(P>0.05)。多因素logistic回归分析显示,月龄较大是体外循环术后防止乳酸水平升高的保护因素(P<0.05),体外循环时间、主动脉阻断时间较长及体内高葡萄糖水平是体外循环术后乳酸水平升高...

Analysis of correlation between lactate level and blood glucose,oxygenation indexes in low-month-old and low-weight children treated with cardiopulmonary bypass

ObjectiveTo analyze the correlation between lactate level and blood glucose, oxygenation index in low-month-old and low-weight congenital heart disease children treated with cardiopulmonary bypass.MethodsOne hundred and twenty-nine congenital heart disease children treated with cardiopulmonary bypass were divided into the high lactate group(n=43) and normal lactate group(n=85) according to the lactate level after 6 h of surgery.The operation-related indexes, and levels of glucose, and oxygenation indexes were compared between two groups.The multivariate logistic regression model was used to analyze the influencing factors of lactate level in children after operation.The Pearson correlation model was used to analyze the correlation between lactate level and glucose, oxygenation index in children after 6 hours of operation.ResultsThe extracorporeal circulation time, aortic occlusion time, glucose and lactate levels in high lactate group were higher than those in normal lactate group(P < 0.05 to P < 0.01).The differences of arterial oxygen saturation(SaO₂) and venous oxygen saturation(SvO₂) (SaO₂-SvO₂) levels and incidence rate of ketosis were not statistically significant between two groups(P>0.05).The results of multivariate logistic regression analysis showed that the older age was a protective factor to prevent the increasing of lactate level after cardiopulmonary bypass(P < 0.05), the extracorporeal circulation time, aortic occlusion time and high glucose level were the independent risk factors of the increasing of lactate level after cardiopulmonary bypass(P < 0.05 to P < 0.01).The results of Pearson correlation analysis showed that the lactate level was significantly positively correlated with glucose(P < 0.01), but had no significant correlation with(SaO₂-SvO₂) level(P>0.05).ConclusionsThe lactate level in low-month-old and low-weight children after 6 h of cardiopulmonary bypass is correlated with the glucose level, but not with oxygen intake.