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特发性脊柱侧弯患者全身麻醉控制性低血压期间肺内分流及血乳酸的变化

[Changes in pulmonary shunting and blood lactate during general anesthesia with controlled hypotension in patients with idiopathic scoliosis].

作者信息

Cundrle I, Vlach O, Dastych M

出版信息

Acta Chir Orthop Traumatol Cech. 1989 Jul;56(4):358-64.

PMID:2800869
Abstract

In their work the authors observed the influence of controlled hypotension by means of sodium nitroprusside on the acidobasic balance, the oxygenation parameters, pulmonary shunt and lactatemia in patients with idiopathic scoliosis in the course of dorsal fusion by Harrington instrumentation. In comparison with the control group of patients there had not occurred significant - from the viewpoint of statistics - changes in ph, paCO2 and pvO2. However, the pulmonary shunt (Qva/Qt) doubled (p less than 0.002) which resulted in a significant decrease of paO2 (p less than 0.02) but in no case there occurred hypoxemia. The values of the lactate both in the venous and arterial blood were increased (p less than 0.001, or p less than 0.02) in contrast to the control group of patients, but they did not mean the increased production of lactate during intracellular hypoxia. As a result the regulated hypotension by means of sodium nitroprusside can be applied also in patients with altered pulmonary functions.

摘要

作者在其研究中观察了硝普钠控制性低血压对特发性脊柱侧凸患者在哈林顿器械后路融合术中酸碱平衡、氧合参数、肺分流和乳酸血症的影响。与对照组患者相比,从统计学角度来看,pH值、动脉血二氧化碳分压(paCO2)和静脉血氧分压(pvO2)未发生显著变化。然而,肺分流(Qva/Qt)增加了一倍(p<0.002),导致动脉血氧分压(paO2)显著降低(p<0.02),但未出现低氧血症情况。与对照组患者相比,静脉血和动脉血中的乳酸值均升高(p<0.001或p<0.02),但这并不意味着细胞内缺氧时乳酸生成增加。因此,硝普钠控制性低血压也可应用于肺功能改变的患者。

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