摘要目的 探讨低温体外循环心脏术后复温过程中体温变化对血乳酸水平及氧代谢的影响,为合理控制患者体温提供依据.方法 对60例低温体外循环心脏术后患者进行监测,分别在肛温37,37.5,38,38.5℃时采集动、静脉血标本,检测动静脉血氧代谢及血乳酸值.结果 复温时全身的氧耗量明显增加;动脉血乳酸值在肛温37.5℃时最接近正常,37,38℃时次之,肛温38.5℃时血乳酸值最高(高乳酸血症),差异有统计学意义.结论 在低温体外循环心脏术后复温过程中,体温变化是影响氧耗量和血乳酸水平的重要因素,护理人员应将患者体温控制在37.5℃左右的安全范围内.

abstractsObjective To investigate the effects of body temperature change on the level of arterial blood lactic acid and oxygen metabolism after the hypothermic cardiopulmonary bypass(CPB),and to provide a basis for controlling body temperature of patients.Methods 60 patients performed the open cardiac operation under hypothermic cardiopulmonary bypass were monitored.The arterial and mixed venous blood gas,and the level of lactic acid were measured at four different rectal temperatures:37,37.5,38℃ and 38.5℃,by taking samples of arterial and venous bloods.Results The systemic arterial-venous oxygen content and oxygen extraction were increased during rewarming time.The level of arterial blood lactic acid at the rectal temperature of 37.5℃ mostly approachs the nornlal value.next is at the rectal temperature of 37℃ and 38 ℃,respectively.And the level of arterial blood laetic acid at the rectal temperature of 38.5℃ is the hilghest (hyperlactacidemia).The difference shows a statistically significance.Conclusions During the rewarming process after the hypothermic cardiopulmonary bypass(CPB),the body temperature change is a key factor influencing oxygen extraction and blood lactic acid level.The nursing staff should control the body temperature of patients with the safe range of around 37.5℃.