肝移植患者术后电解质及乳酸变化的研究

目的了解肝移植患者术后24h内电解质和乳酸的变化规律，总结肝移植术后有效电解质平衡和乳酸代谢情况的监测及护理措施，为规范肝移植术后护理程序提供依据。方法对147例肝移植患者分别于术前（T）、术后返ICU即刻（TO）、术后24h（T1）行生化血清钠、钾、钙的检测，并于术后1D和T1行床旁血气分析，记录乳酸值，进行统计分析。结果患者术后24h内血钠持续较术前升高（P〈0．01），但仍在正常范围；血钾与手术前比较差异无统计学意义（P〉0．05）；血钙在患者术后返ICU即刻较术前明显降低，至术后24h升至术前水平；术后返ICU即刻患者乳酸值水平较正常值异常增高，至术后24h较返ICU即刻明显降低（P〈0．01）。结论肝移植患者术后24h内应加强电解质及乳酸的监测，合理调节电解质平衡，促进乳酸正常代谢。

Research on variation of electrolyte and lactate in patients after liver transplantation

Objective To understand and analyze variation of electrolyte and lactate in patients with liver transplantation during 24 hours after operation:To offer effective and standard nursing intervention and monitoring.Methods 147 cases of liver transplantation patient were detected with blood lab data before peration,immediately after entered ICU and 24 hours after operation.Results Thore was no significant difference in serum potassium between pre-operation and post-operation.Serum sodium continued to increase but still within the normal range during 24 hours after operation and serum calcium significantly decreased before it increased to pre-operation level.Lactate jn the patients immediately after entered to ICU was higher than normal level and it significantly decreased at 24 hours after operation.Conclusions The electrolyte and lactate should be monitored and adjusted on time to improve lactate metabolism for the liver-transplanted patients during first 24 hours after operation.