体外循环心脏手术中脑自身调节的变化

被引：10

作者：

于灵芝

大西佳彦

畔政和

机构：

[1] 山东省立医院麻醉科

[2] 日本国立循环器セニタ病麻醉科

[3] 日本国立循环器セニタ病麻醉科济南

来源：

中华麻醉学杂志 | 2001年 / 02期

关键词：

脑血管循环; 体内稳态; 颈静脉; 血氧测定法; 心脏手术; 心肺转流术;

D O I：

暂无

中图分类号：

R654.1 [体外循环及复苏术];

学科分类号：

1002 ; 100210 ;

摘要：

目的　采用颈静脉球氧饱和度 (SjO2 )持续监测 ,以平均动脉压 (MAP)变化对SjO2 的影响及二者的相关关系作为评定脑自身调节的指标 ,对心脏手术病人术中脑自身调节功能进行估测。方法　 2 4例心脏手术病人 ,男 16例 ,女 8例 ,ASA分级Ⅱ Ⅲ级 ,术前无神经系统病变、糖尿病及免疫系统疾病 ,术后无神经精神障碍表现。采用α stat原则维持血液酸碱平衡。采用计算机化麻醉监测记录系统持续监测SjO2 、MAP、体温、心率、肺动脉压、心排量等 ,采样间隔为 30s。分析CPB前、CPB中稳定低温期、CPB后血温下降期各 45 6 0minMAP与SjO2 的相关关系 ,并求出直线回归方程SjO2=b +aMAP。以斜率a为标准 ,a≥ 0 4为脑自身调节失常。结果　转流前无自身调节失常 ,转流后 4例 (16 7% )出现脑自身调节失常 ,其中 2例转流中即已存在。a值大小与主动脉阻断时间及CPB时间无关。 5例病人在不同的时间段内平均SjO2 低于 5 0 % ,但并未发生脑自身调节失常。结论　以MAP与SjO2 的相关性变化为标准对体外循环心脏手术中脑血管反应性进行持续观察发现 ,体外循环心脏手术中可发生一过性脑自身调节失常

引用

页码：12 / 16

页数：5

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