体外循环中空气法胃粘膜pH值与氧供氧耗的变化医学.docVIP

体外循环中空气法胃粘膜pH值与氧供氧耗的变化医学 目录 TOC \o 1-9 \h \z \u 目录 1 正文 1 文1：体外循环中空气法胃粘膜pH值与氧供氧耗的变化医学 1 1 临床资料 2 2 结果 4 3 讨论 4 文2：冻藏期间金枪鱼的TVBN脂肪氧化PH值的变化 5 141毫升1N盐酸标准液相当于氮的毫克数 7 参考文摘引言： 10 原创性声明（模板） 11 文章致谢（模板） 12 正文 体外循环中空气法胃粘膜pH值与氧供氧耗的变化医学 文1：体外循环中空气法胃粘膜pH值与氧供氧耗的变化医学 【Abstract】 Objective To observe the change of gastric air tonometric pH, oxygen delivery ,oxygen coumption and gastric mucosal perfusion during cardiopulmonary bypass (CPB), during CPB. Methods Thirty elective cardiac surgery patients were observed. Gastric PCO2 was measured from a nasogastric tube by an automated system of air tonometry. Record the arterial and mix venous blood-gas results in after indication 30 min, CPB30 min, CPB 60 min, 30 min and 60 min after the end of CPB. Input these blood-gas results to the monitor calculated the pHi, oxygen delivery and oxygen coumption in these observe points. Results PgCO2 during CPB was significantly lowered compared with that of preoperation (P), and returned to preoperation level when after CPB. pHi during CPB was significant up veus preoperation (P), and returned to preoperation level when after end the CPB. DO2 and VO2 in during CPB were significantly lower preoperation (P), those after CPB were significantly higher than those during CPB (P). Conclusion The patient’s gastric mucosal perfusion is maintained well during hypothermic CPB. 【Key words】 Cardiopulmonary bypass Air Tonometry Intramucosal PgCO2 Gastromucosal pH Oxygen delivery Oxygen coumption 体外循环(CPB)中的独特生理状态可能导致的全身炎性反应综合征，血液与CPB管道和氧合器的接触所引起的补体、凝血系统的激活及组织的损伤等可能引起内脏器官缺血，国内采用空气法胃粘膜二氧化碳分压(PgCO2)监测CPB中胃粘膜pH值变化的报道较少。作者自2004年2月至2006年10月观察心脏手术CPB患者空气法胃粘膜pH值（pHi）与氧供（DO2）、氧耗（VO2）的变化，现报道如下。 1 临床资料 一般资料 随机选择30例CPB的心脏手术患者，男18例，女12例；年龄（±7）岁；体重（±）kg。主动脉瓣置换7例、冠状动脉架桥4例、主动脉瓣和二尖瓣置换6例、主动脉瓣和二尖瓣置换加三尖瓣成形13例。 方法 术前30min肌注哌替啶50mg，东莨菪碱。入手术室后平卧予面罩吸氧，监测心电图、无创血压和经皮氧饱和度（Datex-Ohmeda S/5，芬兰）。开放外周静脉，局麻下完成桡动脉穿刺置管，监测有创动脉压。咪达唑仑、芬太尼5～10μg/kg、哌库溴胺～/kg麻醉诱导后行气管插管，纯氧机械通气，潮气量8～10ml/kg、频率12次／min、吸呼比1:，吸入1～2%异氟烷、2～5mg