【作者】 刘彬； 许卫江； 梁艳娥；

【机构】 武汉亚洲心脏病医院ICU；

【摘要】 目的:探讨58例心脏术后混合静脉血氧饱和度及动脉血乳酸监测的临床意义。方法:58例病人分别于心脏术后入ICU时（Ⅰ组）及术后6～12h（Ⅱ组）,分别测定动脉血PH值、氧分压（PaO₂）、氧饱和度（SaO₂）和混合静脉血pHv值、氧分压（PvO₂）、氧饱和度（SvO₂）及计算出氧利用率（O₂ER）。并按SvO₂均数分为≤65%（A组,n=12）、>65%且乳酸清除率小于10%（B组,n=25）、>65%且乳酸清除率达10%（C组=21）三组。统计三组患者的ICU停留时间、在院期间并发症发生数。结果:心脏术后病人的氧耗明显增加,SvO₂与O₂ER呈明显的负相关,A组术后并发症发生率、带呼吸机时间及ICU停留时间和B、C组间有显著差异。结论:SvO₂、乳酸是衡量心脏术后病人组织氧供需平衡的良好指标。心脏术后早期SvO₂、乳酸水平可影响术后并发症的发生。更多还原

【Abstract】 Objective:Clinical meanings of lactate clearance and mixed venous oxygen saturation were studied in 58 patients after cardiac surgery.Methods:Measurement of arterial blood pH、PaO₂、SaO₂ lactate and mixed venous blood pHv、SvO₂ was carried out respectively at the same time and O₂ER was calculated.The data of groupⅠwere half an hour after operation,The data of groupⅡwere 6 to 12 hours after operation.And the data were also divided into two groups according to the means of SvO₂≤65%（group A,n=11）, SvO2>65%and lactate clearance<10%（group B, n=25）,SvO2>65%and lactate clearance≥10% （group B,n=21）.Data on duration of ICU stay and the incidence of inpatient complications were collected prospectively.Results:The increase of oxygen consumption in the patients after cardiac surgery was evident.These data revealed a close correlation between SvO2 and O₂ER.The incidence of inpatient complications and duration of ICU stay in group A were statistically significantly different from group B、C,The incidence of inpatient complications in group B were statistically significantly different from group C.Conclusion: SvO₂ and lactate clearance are ideal standard of measurement of oxygen equilibrium in the patients with cardiac surgery.Value of SvO₂ and lactate clearance in early period after heart operation would significantly affect the incidence of complications.更多还原