摘要
目的研究原位肝移植(OLT)术中输注醋酸林格氏液(勃脉力A)对术中动脉血-呼气末CO2分压差(Pa-ETCO2)的影响。方法44例全麻下OLT中病人随机分为2组,术中分别静脉输入勃脉力A(PA组)和乳酸林格氏液(LR组),术中晶体液的输注速率为6~8 ml/(kg.h)。于麻醉前(T1)、门静脉阻断前(T2)、下腔静脉阻断后10 min(T3)、下腔静脉开放后10 min(T4)、手术结束时(T5)采动脉血测动脉CO2分压(PaCO2),同时记录相应的呼气末CO2分压(PETCO2),计算PaCO2和PETCO2的差值(Pa-ETCO2)的大小。结果两组间Pa-ETCO2比较无统计学差异(P>0.05),组内比较Pa-ETCO2差异有统计学差异(P<0.05)。与T1比较,两组在T3、T4上升明显(P<0.05)。结论在OLT术中输入勃脉力A和乳酸林格氏液对PETCO2的影响无统计学差异,但在阻断和开放后都有增大的趋势,需增大每分钟通气量,以增加CO2的排出。
Objective To compare the effects of Acetated Ringer′s solution and lactated Ringer′s solution on differences of carbon dioxide concentration in arterial blood(PaCO2)and end-expiratory(PETCO2)during orthotropic liver transplantation(OLT).Methods Forty-four ASA II^IV patients undergoing OLT were randomly allocated into 2 groups: LR group given lactated Ringer′s solution and PA group given acetated Ringer′s solution(plasma-lyte A solution;Baxter).The crystalloid solutions were infused at rate of 6~8 ml/(kg·h).The concentrations of carbon dioxide were measured in arterial blood before anesthesia(T1 baseline) and cross-clamping of the portal vein(T2),and 10 minutes after cross-clamping of the inferior caval vein(T3),10 minutes after unclamping of the inferior caval vein(T4)and at the end of surgery(T5).The differences of PaCO2 and PETCO2(Pa-ETCO2)was calculated.Results There were no statistical differences between the amount of crystalloid,colloid and blood products infused during operation between 2 groups(P>0.05).There were no statistical differences in Pa-ETCO2 between two groups(P>0.05),but there were statistical differences in the group(P<0.05).The Pa-ETCO2 increased significantly at T3 and T4 compared to the baseline value at T1(P<0.05).Conclusion Acetated Ringer′s solution and lactated Ringer′s solution had no effects on Pa-ETCO2 during OLT without veno-venous bypass,but Pa-ETCO2 tended to increase after clamping and unclamping.The amount of ventilation should be increased to discharge carbon monoxide.
出处
《吉林医药学院学报》
2007年第2期72-74,共3页
Journal of Jilin Medical University
关键词
醋酸林格氏液
肝移植
CO2分压差
acetated Ringer′s sodium
Liver transplantation
Pa-ETCO2
