【摘要】 目的观察胃粘膜二氧化碳分压(PgCO2)与动脉血二氧化碳分压(PaCO2)之差PCO2间隙(PCO2gap)以及胃粘膜pH(i-pH)值在心内直视手术心肺转流(CPB)期间的监测作用。方法15例心内直视手术病人,于手术开始时、CPB 30~45 min、心脏复跳后30 min和手术结束时测定PgCO2、PaCO2和i-pH值,计算PCO2gap。结果与转流前比较,CPB期间i-pH值显著降低(P<0.05),PCO2gap显著增高(P<0.01);心脏复跳后,这些改变甚至更明显(P<0.05)。结论临床CPB期间确实存在胃粘膜低灌流和酸中毒,胃粘膜产生CO2增加,且此低灌流状态于循环恢复后仍持续存在。PCO2gap和i-pH监测在CPB病人中的组织集合。更多还原

【Abstract】 Objective To investigate the changes of gastric intramucosal PCO₂gap（PgCO₂-PaCO₂）and gastric intramucosal pH（i-pH） during cardiopulmonary bypass（CPB）.Methods A clinical study was carried out in 15 patients undergoing open heart surgery.PgCO₂,PaCO₂ and i-pHwere measured and PCO₂ gap was calculated before CPB,30～45min during CPB,at 30min after recovery of heart beating and at the end of operation.Results Comparedwith those before CPB,i-pH decreased（P<0.05） and PCO₂gap increased（P<0.01） significantlyduring CPB,which existed and were even worse（P<0.05）.Conclusion There were gastric mucosal hypoperfusion and acidosis during CPB,which existed continually after circulation resumed.The gastric intramucosal PCO₂gap and i-pH monitoring during CPB is beneficial to the evaluating of tissue oxygenation.更多还原