CAJ | 학술논문

目的：研究体外循环心脏手术围术期血乳酸水平与相关因素的关系。方法采用随机数字表法将404例体外循环心脏患者经手术后分为生存组（n=394）与死亡组（n=10），分别于转机前、转中阻断升主动脉后、停机时、术后24 h记录乳酸浓度，分析围术期血乳酸水平变化趋势与性别、年龄、阻断时间及生死预后的关系。结果术中体外循环停机时及术后24h对应的死亡组乳酸值（3.65±0.49、3.93±0.49）明显高于存活组乳酸值（1.77±0.03、2.79±0.05）（P＜0.05）；≤14岁的患者在手术中阻断升主动脉后的乳酸水平（2.82±0.04）、体外循环停机时乳酸水平（3.10±0.05）、术后24 h乳酸水平（1.94±0.03）均高于年龄＞14岁的患者各时点对应的乳酸水平（1.56±0.05、2.01±0.07、1.52±0.08）（P＜0.05）；升主动脉阻断时间大于120 min组停机时乳酸值（3.47±0.49）及术后24 h的乳酸值（3.24±0.75）明显高于其他3组，差异有统计学意义有意义（P＜0.05）；性别与乳酸水平无明显相关，统计学上无意义。结论动态血气分析反映乳酸水平及趋势及与相关因素的关系，为临床评估及判断提供依据。
목적：연구체외순배심장수술위술기혈유산수평여상관인소적관계。방법채용수궤수자표법장404례체외순배심장환자경수술후분위생존조（n=394）여사망조（n=10），분별우전궤전、전중조단승주동맥후、정궤시、술후24 h기록유산농도，분석위술기혈유산수평변화추세여성별、년령、조단시간급생사예후적관계。결과술중체외순배정궤시급술후24h대응적사망조유산치（3.65±0.49、3.93±0.49）명현고우존활조유산치（1.77±0.03、2.79±0.05）（P＜0.05）；≤14세적환자재수술중조단승주동맥후적유산수평（2.82±0.04）、체외순배정궤시유산수평（3.10±0.05）、술후24 h유산수평（1.94±0.03）균고우년령＞14세적환자각시점대응적유산수평（1.56±0.05、2.01±0.07、1.52±0.08）（P＜0.05）；승주동맥조단시간대우120 min조정궤시유산치（3.47±0.49）급술후24 h적유산치（3.24±0.75）명현고우기타3조，차이유통계학의의유의의（P＜0.05）；성별여유산수평무명현상관，통계학상무의의。결론동태혈기분석반영유산수평급추세급여상관인소적관계，위림상평고급판단제공의거。
Objective Relations bypass heart surgery perioperative blood lactate levels and related factors.Methods With a random number table monitoring 404 cases in our hospital patients after cardiopulmonary bypass surgery into survival group and death group, perioperative blood lactate levels, respectively, before turning, turn in blocking the ascending aorta, shutdown , lactate concentration after 24h record, analyze perioperative blood lactate levels and trends of their gender, age, blocking time and death prognosis.Results Survival group and lactate values at each time point of death group, the group of death in cardiopulmonary bypass surgery and 24h after the death of the corresponding lactate values (3.65 ± 0.49,3.93 ± 0.49) was signiifcantly higher than the survival group lactate values (1.77 ± 0.03,2.79 ± 0.05), ≤14 years were blocked at each time point after aortic surgery in lactate levels (2.82 ± 0.04) during cardiopulmonary bypass lactate levels (3.10 ± 0.05) after 24h lactic levels (1.94 ± 0.03) were higher than those aged> 14 years were at each time point corresponding lactate levels (1.56 ± 0.05,2.01 ± 0.07,1.52 ± 0.08); aortic clamping time greater than 120min constituency down lactic acid value (3.47 ± 0.49) and postoperative lactate value 24h of (3.24 ± 0.75) was signiifcantly higher than that of aortic clamping time 120min constituency larger than the other three groups, statistically signiifcant compared (P<0.05) shutdown when the value of 24h and postoperative lactate increased signiifcantly; ≤14 years were blocked at each time point after the ascending aorta during surgery lactate values were higher than those aged> 14 years were; gender and lactate levels were not significantly correlated , statistically insignificant Conclusion Dynamic lactate levels and blood gas analysis to reflect trends and relationships with related factors provide a basis for clinical assessment and judgment.