小儿腹部大手术后碱中毒的发生及电解质的改变

摘要

对35例小儿腹部大手术巨结肠根治术患儿,手术前后体内水,电解质及酸碱内环境的改变进行了动态观察.结果发现:大手术患儿术后血钾明显下降,术后1、3天碱中毒的发生率分别为42.9%,28.6%,说明碱中毒与低血钾互为因果关系是巨结肠根治术后最常见的电解质及酸碱平衡紊乱,术后应及时补充钾及慎用碱性药物.%The chznges of the fluid,electrolyte and acidbase balance in blood were observed in 35 postoperative children with Hischsprung's disease.The results showed:hypokalemia appeared on the first and the third day but recovered to normal potassium lave1 on the 7th day;the incidence of alkalosis is 42.9% and 28.6% on the first and the 3rd day respectively;incidence of alkalosis in hypokalemic children was higher than that in children with normal potassium level.The authors believe that there would be a correlation between hypokalemia and alkalosis;hypokalemic alkalosis is the most common acid-base pattern in the postoperative children with Hischsprung's disease.The authors suggest:(1) blood gas and electrolyte should be monitored;(2) drugs that may cause alkalosis should be avoided;(3) if there is too much naso-gasteric drainage,potassium level should be checked up.