血气分析在体外循环手术围术期的应用及意义探讨

目的：为正确评价血气指标对体外循环（ＣＰＢ）围术期监测的意义。方法：对７５例心脏 病人ＣＰＢ围术期４９７例次的血ｐＨ、ＡＢ、ＢＥ、ＰＣＯ_２、ＰＯ_３及Ｋ~＋、Ｎａ~＋、Ｃｌ~－的测定结果进行分析。 结果： １．以ｐＨ正常及轻度碱血症占多数（４２％及２９％），酸碱失调的主要原因为代谢性因素； ２． ＰＯ_２多升高（６８％）；３．Ｋ~＋，Ｃｌ~－多在正常水平（８０％，６３％），Ｎａ~＋约一半高于正常（４７％）。结论： 围术期应注意①控制碳酸氢钠的投入，谨防代谢性碱中毒；②密切监测ＰＯ_２，避免ＰＯ_２过高；③防 止钢水潴留。

An Investigation of the Application and its Significance of Blood Gas Analysis During Peri-operation of Cardiopulmonary Bypass

Objectioned:To evaluate the significance of blood gas and electrolyte analysis in monitoring of cases with pert-operation of cardiopulmonary bypass(CPB). Methods: pH, AB, BE, PCO_2, lev- els of K~+, Na~+, CI~- in artery blood were dynamically measured for 497 times in 75 cases with peri-operation of CPB by using NOVA pH/bldri gas analyzer. Results: (1) Moot of the tests showed normal pH or mild alkalosis, the reason for the acid-base dyseqilibrium might be mainly metabolic factors. (2)Most of the tests indicated increased PO_2; (3)The majority of the tests sug- gested that the concentrations of blood K~+ and Cl~- were within normal range (80. 3% and 63. 2% respectively),and about half of them (46. 8% )showed that the concentration of blood Na~+ was higher than normal level. Conclusion: In the present group of patients the concentration of blabs K~+, CI~- and PCO_2 were well controlled, however, the following treatment should be paid much at- tention to: (1)The administration of NaHCO_3 must be Carefully controlled in order to avoid metabolic al- kalosis; (2)Make a close observation of PO_2,to avoid too high PO_2,which may effect harmfully on human body; (3)The administration of saline must be suitable,otherwise the retention of water and sodium might happen.