血乳酸监测在颅内肿瘤术后的临床意义

目的探讨血乳酸在颅内肿瘤术后的意义。方法对2014年1月-2015年12月颅内肿瘤患者107例,术前行血气分析,术后0、3、6、12、24、48、72小时行血气分析,记录血乳酸值。监测术后3小时ICP及平均动脉压。计算脑灌注压(CPP:平均动脉压-ICP)。结果部分颅内肿瘤患者术后血乳酸有不同程度增高,与术后是否并发脑出血及脑灌注压低有相关性(P0.05)。结论颅内肿瘤患者术后血乳酸增高并非一定提示容量不足,血乳酸动态监测评价术后患者颅内情况有重要意义。

Clinical significance of blood lactic acid monitoring after surgeries for intracranial tumors

Objective To investigate the clinical significance of blood lactic acid after surgeries for intracranial tumors.Methods A total of 107 patients with intracranial tumors who were treated from January 2014 to December 2015 were enrolled. Blood gas parameters were measured before surgery and at 0, 3, 6, 12, 24, 48, and 72 hours after surgery, and the blood lactic acid concentrations were recorded. Intracranial pressure (ICP) and mean arterial pressure were measured at 3 hours after surgery. Cerebral perfusion pressure (CPP) was calculated according to the equation of CPP=mean arterial pressure-ICP.Results Some patients experienced varying degrees of increase in blood lactic acid concentration, which was associated with postoperative cerebral hemorrhage and low CCP (P<0.05).Conclusions In patients with intracranial tumors, the increase in blood lactic acid concentration after surgery does not always suggest blood volume deficiency, and dynamic blood lactic acid monitoring has a great significance in evaluating intracranial condition after surgery.