目的:评价不同电解质溶液用于体外循环心脏手术血液洗涤的效果。方法:选体外循环下心脏手术患者60例，年龄18~80岁，体重50~100 kg，预计术中需要输注库存血4~6 U。采用随机数字表法分为3组(n n＝20)：复方电解质注射液组(A组)、碳酸氢钠林格液组(B组)和生理盐水组(C组)，分别采用复方电解质注射液、碳酸氢钠林格液和生理盐水对库存血和回收的自体血进行洗涤。于洗涤前和洗涤后即刻，取库存血和自体血行血气分析，采用比色法检测红细胞渗透脆性，采用ELISA法检测2，3-二磷酸甘油酸(2，3-DPG)浓度。n 结果:与洗涤前比较，3组洗涤后库存血Glu、Lac、Kn +浓度和红细胞渗透脆性降低，Nan +浓度升高，自体血Glu和Lac浓度降低，红细胞渗透脆性升高，库存血和自体血2，3-DPG浓度升高(n P<0.05)；与C组比较，A组和B组洗涤后库存血和自体血Nan +和Cln -浓度降低，Kn +浓度升高，红细胞渗透脆性降低，2，3-DPG浓度升高(n P<0.05)；与A组和C组比较，B组洗涤后库存血和自体血BE升高(n P<0.05)。洗涤后B组库存血和自体血可检测到Can 2+，而A组和C组库存血和自体血无法检测到Can 2+。n 结论:复方电解质注射液和碳酸氢钠林格液用于体外循环心脏手术血液洗涤的效果明显优于生理盐水，其中碳酸氢钠林格液还能改善血液偏酸无钙的内环境。“,”Objective:To evaluate the effects of different electrolyte solutions on blood washing in cardiac surgery with cardiopulmonary bypass (CPB).Methods:Sixty patients, aged 18-80 yr, weighing 50-100 kg, undergoing cardiac surgery with CPB with expected banked blood transfusion 4-6 U in our hospital, were divided into 3 groups (n n=20 each) by a random number table method: compound electrolyte injection group (group A), sodium bicarbonate Ringer′s solution group (group B) and normal saline group (group C). Banked blood and salvaged autologous blood were washed with compound electrolyte injection, sodium bicarbonate Ringer′s solution and normal saline.Banked and autologous blood was collected before washing and immediately after washing for blood gas analysis.The osmotic fragility of red blood cells was measured by colorimetry, and the concentration of 2, 3-diphosphoglycerate (2, 3-DPG) was determined by enzyme-linked immunosorbent assay.n Results:Compared with the baseline before washing, the concentrations of Kn +, Glu and Lac in banked blood were significantly decreased, the concentrations of Kn + in banked blood were increased, and the concentrations of Glu and Lac in autologous blood were decreased, the osmotic fragility of erythrocytes was increased, and the concentrations of 2, 3-DPG in banked and autologous blood were increased after washing in the three groups (n P<0.05). Compared with group C, the concentrations of Nan + and Cln - in banked and autologous blood were significantly decreased, the concentrations of Kn + in banked and autologous blood were increased, the osmotic fragility of erythrocytes in banked and autologous blood was decreased, and the concentrations of 2, 3-DPG in banked and autologous blood were increased in A and B groups (n P<0.05). Compared with A and C groups, BE in banked and autologous blood were significantly increased after washing in group B than in A and C groups (n P<0.05). After washing, Can 2+ was detected in banked and autologous blood in group B, however, Can 2+ was not detected in banked and autologous blood in group A and group C.n Conclusions:Compound electrolyte solution and sodium bicarbonate Ringer′s solution provide better efficacy when used for blood washing in cardiac surgery with CPB, and sodium bicarbonate Ringer′s solution can also improve the acidic and calcium-free internal environment of blood.