| Objective: Rheumatic heart disease is a commondisease ,which severely threatens human's health and mostlyneeds operation treatment. The monitoring of patients during theperioperation period is vital, which can not only give guides toclinic therapies, but better enhance the patients'restore. Thepatients of rheumatic heart disease easily develop electrolytedisorder because of long disease history, cardiac disfunction anddrug's side effect, and so on. All these will increase the dangerof operation and affect the patients'restore.In addition, because cardiopulmonary bypass is anon-physiological process, if the process is long, which willmore interfere with the body's normal metabolism and result inelectrolyte disorder.At present, it generally makes the electrolyte examinationby way of venous blood, but serum levels canot truly representthe body's levels, especielly for severe cases owing to ionizedK+,Na+,Mg++ different distribution in body and each specialmetabolism.The rheumatic heart disease patients often have a lung disfunction and need assisted respiratory, which will result inrespiratory failure and badly need blood gas analysis. Butfor severe cases the levels of artery blood gas cannotdemonstrate the truth in time.In recent years, with the development of the research andtechnology, the medicine has a great improvement. Theintra-cell electrolyte and blood gas will provide a bettersuggestion for clinic medical workers and have a moresignificane. The aim of our experiment is to study the role ofintra-red blood cell blood gas and elctrolyte in rheumatic heartdisease patieats.Methods: We chose twenty rhumatic heart diseasepatients(RHDgroup) and twenty congenital heart diseasepatients(CHDgroup) at random in our cardiac department.Blood samples,which were collected from artery at the definedtime points in both grougs: 24 hours before operation, 20minutes after cardiopulmonary bypass , before aortic cross–clamp removal, the end of cardiopulmonary bypass, the end ofoperation, 24 hours after operation, were measured the bloodgas and electrolyte of both serum and intra-red blood cellmeanwhile, observing changes of blood gas and electrolyte ofboth serum and intra-red blood cell at every time in both groupsand drawing graphs and tables, reporting the patients'generalconditions,details of cardiopulmonary bypass and arrhythmiasetc.Results: There was no demographic difference in sex andweight in two groups, however, aortic cross-clamp time,ventricular arrhythmias after operation reached statisticalsignificance in two groups. The concentration of serum kalium24 hours before operation in rhumatic heart disease patients waslower than that of CHD patients, reaching statistical significance.The levels of serum kalium had no demogrohic difference atother time points between two groups. But the levels of intra-redblood cell ionized kalium in RHD group 24 hours beforeoperation, after 20 minutes of bypass , before aortic cross–clampremoval, the end of cardiopulmonary bypass, the end ofoperation, 24 hours after operation were lower than those ofCHD group. The levels of serum kalium decreased after 20minutes of bypass in both groups, which had statisticalsignificance compared with that of 24 hours before operation.The levels of serum kalium in both groups at restoring heart beat,the finishing of bypass, the end of operation were higher thanthose at 20 miutes after bypass, having statistical significance.The levels of intra-red blood cell kalium in two groupsincreased from the beginning of cardiopulmonary bypass to 24hours after operation. The oxygen pressure of blood andintra-red blood cell in two groups increased from the beginningto the end of operation. The concentration of intra-red blood cellkalium in patients with ventricular fibrillation in RHD groupafter the aortic cross-clamp removal was lower than that inpatients without ventricular fibrillation.Conclusions: The concentration of serum kalium 24 hoursbefore operation in rhumatic heart disease patients was lower... |
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