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Effects of Different Hypothermia on Cerebral Oxygen Metabolism During Cardiopulmonary Bypass
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- Author:
- No author available
- Journal Title:
- JOURNAL OF CHINESE PHYSICIAN
- Issue:
- 12
- DOI:
- 10.3760/cma.j.issn.1008-1372.2002.12.012
- Key Word:
- 不同低温;体外循环;脑氧代谢
Abstract： 目的观察不同低温麻醉下体外循环(CPB)对脑氧代谢的影响.方法心脏瓣膜置换手术患者20例,随机分为浅低温组(30℃)和中低温组(26℃).在α稳态下,通过桡动脉和颈内静脉球部血液的动态血气分析及乳酸浓度测定,计算全身动脉及颈内静脉的血氧含量、动-颈内静脉血氧含量差、脑氧摄取率和动-颈内静脉乳酸浓度差.结果 CPB开始后,两组的动脉血氧含量、动-颈内静脉血氧含量差和脑氧摄取率迅速下降(P＜0.01,P＜0.05),随着复温又迅速升高.在最低温度点时,组Ⅰ的动-颈内静脉血氧含量差、脑氧摄取率高于组Ⅱ(P<0.05;P<0.01).两组的乳酸浓度进行性升高,但各温度点的动-颈内静脉血的乳酸浓度差无明显变化(P＞0.05),始终接近零值.停CPB时,两组的动-颈内静脉血氧含量差仍明显低于转流前水平(P＜0.01).结论浅、中低温麻醉下的体外循环,均可满足CPB过程中的脑氧供需平衡,进一步的体温下降并未取得更好的保护效果.CPB结束后,脑氧代谢可能会继续升高,是否发生脑氧供需失衡值得进一步研究.
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