体外循环中不同晶体液的应用比较.docxVIP

体外循环中不同晶体液的应用比较 【摘要】目的比较醋酸钠林格氏液勃 脉力A和乳酸钠林格氏液两种晶体液在体外 循环心脏手术中的使用结果， 减轻ECCM患 者的生理干扰。方法选取ECOL、脏手术患 者80例随机分为勃脉力A组和乳酸钠林格 氏液组两组，检测基础值及转流过程中的乳 酸、渗透压和电解质的浓度。结果 两组患 者预充液中Lac和钙的浓度有显着差异，停 机时已无统计学意义。渗透压及其它离子浓 度无显着差异。结论ECC中使用勃脉力A优 于乳酸钠林格氏液，可以显着降低预充液中 的Lac浓度，用于输血前后也更安全。该文档为文档投稿赚钱网作品，版权所有，违责必纠 【关键词】体外循环勃脉力A乳酸电解 质 Abstract: OBJECTIVE To compare the effects of utility of plasmalyte-A and lactate ringer s as crystalloid solution in open heart sugery with extracorporeal circulation(ECC).该文档为文档投稿赚钱网作品，版权所有，违责必纠 METHODS Eighty patients, including forty senven patients of the simple congenital heart disease, eighteen patients of the complicated congenital heart disease, fifteen patients of the theumatic heart disease and the coronary atherosclerotic disease, were divided randomly into two groups: plasmalyte-A group(P group) and lactate ringer s group(R group). The concentrations of lactate, osmotic pressure and electrolytes of two groups were measured after priming solution and during ECC. RESULTS The concentrations of lactate and calcium in the priming solution had significant differences between the two groups, those differences were no statistical meaning before the ECC was over. There was no difference in osmotic pressure and other electrolytes ‘ concentration.该文档为文档投稿赚钱网作品，版权所有，违责必纠 CONCLUSION It is better to use plasmalyte- A than lactate ringer ‘ s in该文档为文档投稿赚钱网作品，版权所有，违责必纠 ECC, because the former can significantly decrese the lactate concentration in the priming solution. It is also safer to use plasmalyte-A before and after blood transfusion.该文档为文档投稿赚钱网作品，版权所有，违责必纠 Key words: Extracorporeal circulatio ; Plasmalyte-A ； Lactate ； Electrolyte该文档为文档投稿赚钱网作品，版权所有，违责必纠 心脏外科手术蓬勃发展与体外循环支持息 息相关，而ECC±程中血液直接与异物表面 接触，ECC本身的非生理性灌注，温度，血 液稀释，氧债等各方面因素都会导致乳酸浓 度的升高，高乳酸浓度预示着心脏病手术患 者预后不佳［1］。而ECC中应用乳酸钠林格 氏液稀释血液有可能增加 Lac浓度［2］。为该文档为文档投稿赚钱网作品，版权所有，违责必纠 了降低Lac浓度，使术后患者各项指标更接 近生理，本院采用醋酸林格氏液作为晶体稀 释液，该液体的渗透压、钙、钾等离子浓度 和乳酸钠林格氏液亦有一定区别，因此，本 研究旨在测定Lac浓度变化的同时检测其它 相关离子浓度变化并探讨其优越性。该文档为文档投稿赚钱网作品，版权所有，违责必纠 1资料与方法 一般