动脉血乳酸对行履脏术后患者的病情评估作用.doc

文章编号: 　 动脉血乳酸对心脏术后患者的病情评估作用 王显悦 通讯作者：王显悦. Tel: (020)Email: nnnd@ 作者简介：王显悦. 硕士,主治医师. 张卫达 王晓武 马涛 梅鲁刚 梁爱琼 张琰 （广州军区总医院心脏外科中心，广东 广州 510010） Pathogenetic condition evaluation effect of arterial blood lactic acid on postcardiotomy patients WANG Xian-yue，ZHANG Wei-da，WANG Xiao-wu，MA Tao，MEI Lu-gang，LIANG Ai-qiong，ZHANG Yan Department of Cardiovascular Surgery, the Military General Hospital of Guangzhou Command, Guangzhou Guangdong 510010, China Corresponding author: WANG Xian-yue 【Abstract】Objective：　To identify the pathogenetic condition evaluation effect of arterial blood lactic acid on postcardiotomy patients. 　METHODS：62 postcardiotomy patients were divided into two groups according to arterial blood lactic acid values. The value of 2.0 mmol/L at ICU admission was chosen as the section point for arterial blood lactic acid. The patients with the mean value of less than 2.0 mmol/L (group A) were compared with the remaining patients (group B) on length of ICU stay, ventilation time and frequency of vasoactive agent and alkaline drug use. The recovery of patients and variation tendency of arterial blood lactic acid, PH and BE were recorded from two groups.　RESULTS：In group A, there was one case to which left pulmonary atelectasis occurred. One patient died of low output syndrome in group B. Compared with group A , group B had longer ventilation time and the length of ICU stay ( P 0. 05) ,and higher frequency of vasoactive agent and alkaline drug use ( P 0. 05). Group B had a greater fluctuation on the value of postoperative arterial blood lactic acid, PH and BE. These values fluctuated most 5 hours after operation and regressed gradually back to the normal 15-20 hours after operation. CONCLUSION：The value of Arterial blood lactic acid can be used to evaluate pathogenetic condition of postcardiotomy patients to a certain extent. Patients with high level of arterial blood lactic acid have an unstable pathogenetic condition in earlier postoperation. They need