CAJ | 학술논문

目的探讨肝移植手术后的酸碱平衡变化规律。方法记录肝移植病人40例术中输注红细胞、血浆、碳酸氢钠及乳酸林格的使用量、手术持续时间、术中尿量等；记录肝移植手术前、术后进入重症监护病房当时（入室）、术后第1天、术后第2天、术后第3天、术后第4天、术后第5天的血气分析及乳酸值，并对上述指标进行比较分析。结果 pH、碳酸氢根（HCO3-）、碱剩余（BE）在入室时为最低值，术后第2天pH、二氧化碳分压（ PaCO2）、BE、HCO3-均达到最高值，并随着时间的推移逐渐下降；pH在术后第5天时基本回到术前水平，而PaCO2、BE、HCO3-则高于术前水平。乳酸在入室当时即达到最高值，呈逐渐下降趋势，术后第1天下降最明显。结论加强肝移植术后病人酸碱平衡变化的监测，对肝移植术后的监护和管理有着重要的临床意义。
목적탐토간이식수술후적산감평형변화규률。방법기록간이식병인40례술중수주홍세포、혈장、탄산경납급유산림격적사용량、수술지속시간、술중뇨량등；기록간이식수술전、술후진입중증감호병방당시（입실）、술후제1천、술후제2천、술후제3천、술후제4천、술후제5천적혈기분석급유산치，병대상술지표진행비교분석。결과 pH、탄산경근（HCO3-）、감잉여（BE）재입실시위최저치，술후제2천pH、이양화탄분압（ PaCO2）、BE、HCO3-균체도최고치，병수착시간적추이축점하강；pH재술후제5천시기본회도술전수평，이PaCO2、BE、HCO3-칙고우술전수평。유산재입실당시즉체도최고치，정축점하강추세，술후제1천하강최명현。결론가강간이식술후병인산감평형변화적감측，대간이식술후적감호화관리유착중요적림상의의。
Objective To explore the change rules of acid-base balance after liver transplantation .Methods To record the transfusion volumes of red blood cells ,plasma,sodium bicarbonate and Ringer's lactate,and operation time ,intraoperative urine volume in 40 patients undergoing liver transplantation .The blood gas analysis and lactic acid value were respectively recorded at several time points such as pre-operation,entering intensive care unit(ICU),and the 1st,2nd,3rd,4th and 5th day after operation .An analysis on the indices above was conducted .Results pH,bi-carbonate (HCO3 -),beryllium (BE) were the lowest when patients’ entering ICU.pH,partial pressure carbon diox-ide (PaCO2 ),BE and HCO3 -were the highest on the 2nd day after operation,and they gradually decreased over time;pH returned to preoperative level on the 5 th day after operation while the levels of PaCO 2 ,BE and HCO 3 -were higher than those of the preoperative .Lactic acid value was the highest on the day of entering ICU , which showed a trend of gradual decline , and the decrease was the most significant on the first day after operation .Conclusion Strengthening the monitoring of acid-base balance in patients undergoing liver transplantation has an important clinical significance for management of patients after liver transplantation .