【摘要】 目的:探讨手术病人围术期胃粘膜pH值（pHi）的变化及其临床意义。方法:6例全麻下行腹部盆腔手术的病人,用液体分压计在麻醉前、麻醉后30分钟、术中、术毕、术后最初24小时测定pHi,同时经桡动脉、颈内静脉测定血液动力学、代谢和氧指标。结果:麻醉手术期间胃pHi明显下降（P<0.001）,且大多数低于7.32,pH-gap（pHa-pHi差值）、PCO₂-gag（PiCO₂-PaCO₂差值）明显升高（P<0.005）,在术后最初24小时可恢复到术前水平。仅有1例在术后最初24时小pHi<7.32,且并发右下肢高位静脉血栓。虽pHa、LACT（动脉血乳酸）有同样意义的变化,但反应较晚。结论:手术病人在手术期间可发生与麻醉和手术有关的胃粘膜低灌注,而Phi及其衍生指标是反映这种变化的较好指标。更多还原

【Abstract】 Objective: To investigate perioperative changes of gastrointramucosal pH （pHi） in major operative patients. Method: Six patients underwent major abdominopelvie operation with radial artery and internal jugular vein catheters, and nasogastric tonometries in place. The phi and hemodynamic, oxygen, and metabolic variables were measured simutaneously before anesthesia, 30 minutes after anesthetic induction, during intraoperation, at the end of operation, and the first 24 hours postoperatively. Result: There was significant decrease in mean pHi（P<0.01） and pHi<7.32 in the majority of patients during anesthesia and operation, and it recovered within first 24 hours postoperatively. While pHa, plasma lactate level changes occurred later than that of pHi. PaO₂ and SpO₂ were kept at high levels during anesthesia and operation, but PaO₂ was decreased during 24 hours postoperatively. Conclusion: Gastromucosal hypoperfusion related to anesthesia and operation may occur during a major surgery. pHi and the derivative variables are better indicators for gastromucosal perfusion.更多还原