[摘要]目的：探讨58例心脏术后混合静脉血氧饱和度及动脉血乳酸监测的临床意义。方法：58例病人分别于心脏术后入ICU时（Ⅰ组）及术后6～12 h（Ⅱ组），分别测定动脉血PH值、氧分压（PaO₂）、氧饱和度（SaO₂）和混合静脉血pHv值、氧分压（PvO₂）、氧饱和度（SvO₂）及计算出氧利用率（O₂ER）。并按SvO₂均数分为≤65%（A组，n=12）、>65%且乳酸清除率小于10％（B组，n=25）、>65%且乳酸清除率达10％（C组=21）三组。统计三组患者的ICU停留时间、在院期间并发症发生数。结果：心脏术后病人的氧耗明显增加，SvO₂与O₂ER呈明显的负相关，A组术后并发症发生率、带呼吸机时间及ICU停留时间和B、C组间有显著差异。结论：SvO₂、乳酸是衡量心脏术后病人组织氧供需平衡的良好指标。心脏术后早期SvO₂、乳酸水平可影响术后并发症的发生。

 

Abstract Objective：Clinical meanings of lactate clearance and mixed venous oxygen saturation were studied in 58 patients after cardiac surgery. Methods：Measurement of arterial blood pH、PaO₂、SaO₂ lactate and mixed venous blood pHv、SvO₂ was carried out respectively at the same time and O₂ER was calculated. The data of groupⅠwere half an hour after operation，The data of groupⅡwere 6 to 12 hours after operation. And the data were also divided into two groups according to the means of SvO2≤65%（group A，n=11），SvO2>65% and lactate clearance<10%（group B，n=25）, SvO2>65% and lactate clearance≥10%（group B，n=21） .Data on duration of ICU stay and the incidence of inpatient complications were collected prospectively. Results：The increase of oxygen consumption in the patients after cardiac surgery was evident. These data revealed a close correlation between SvO2 and O₂ER.The incidence of inpatient complications and duration of ICU stay in group A were statistically significantly different from group B、C，The incidence of inpatient complications in group B were statistically significantly different from group C. Conclusion：SvO₂ and lactate clearance are ideal standard of measurement of oxygen equilibrium in the patients with cardiac surgery. Value of SvO₂ and lactate clearance in early period after heart operation would significantly affect the incidence of complications.