原位肝移植术中电解质生化和酸碱的变化

目的重点观察原位肝移植术中电解质、生化和酸碱的变化及麻醉管理。方法选择终末期肝病病人20例,17例采用经典原位肝移植术,3例采用背驼式肝移植术。分别于术前、无肝期前10 min、无肝期30 min、开放前10 min、新肝期10 min、新肝期30 min抽血测血气及各项生化指标。结果整个术中血Na+无显著变化,血K+与术前相比无显著变化,新肝期血K+有下降趋势,血Ca2+无肝期有显著差性下降,无肝期、新肝期存在明显代谢性酸中毒。整个术中血糖逐渐增高。结论肝移植术中电解质和酸碱变化较大,应及时监测及处理,维持内环境相对稳定。

Clinical Observation on Electrolyte Biochemical and Acid Base Changes During Orthotopic Liver Transplantation

Objective To observe the changes of electrolyte,biochemical and acid base as well as management of anesthesia during operation of orthotopic liver transplantation.Methods 20 cases of liver transplantation patient,in which 17 cases underwent classical and 3 cases hunchbacked,were detected with blood lab data at pre-operation,10 min pre-remove liver stage,30 min without-liver stage,10 and 30 min in new liver stage.Results There was no change in Na and serum K had decreased during new-liver stage.The Ca had decreased and metabolic acidosis happened,blood sugar increase significantly during operation.Conclusion The electrolytes and acid base might have great change during operation that should be monitored and treated on time to maintain steady.