小儿体外循环心内直视手术脑电图观察(附两种灌注技术的比较)

MONITORING OF ELECTROENCEPHALOGRAM DURING OPEN-HEART SURGERY:AN ANALYSIS OF 20 CASES

本文探讨20例小儿先天性心脏病体外循环心内直视手术中和术后各阶段的EEG的变化规律。将灌注方法分为两组:冷血组(10例),平均动脉灌注流量为<2.0升/米2/分,灌注血温<10℃;温血组(10例),平均灌注流量为2.4升/米2/分,灌注血温为20~25℃。结果指出:1.术前有6例EEG轻度异常,其中3例在术后恢复正常;2.上下腔静脉插管、转流开始即刻以及术毕心脏复跳前(心脏室颤时)EEG有短时变差。术后1天开始EEG又逐渐变差,至术后2~3天达高峰,以后逐渐恢复,术后2~3周均恢复正常。3.对保护脑组织来说,高流量20~25℃的血温作动脉灌注方法比冷血低流量灌注为优。

The electroencephalograms(EEG)of 20 cases recorded during pediatric open-heartsurgery were analysed.In 10 cases,the arterial perfusion temperature was<10℃andmean perfusion rate<2.0 L/M~2/min,and in the other 10 cases they were 20—25℃and 2.4 L/M~2/min,respectively.The results were:(1)6 cases had slightly abnormalpreoperative EEG,3 of them reverted to normal after operation,(2)EEG was transientlyabnormal during cannula insertion into vena cava,when bypass just began and beforeresuscitation with fibrillating ventricle.Two or three days after operation,the EEGwas again found abnormal and recovered in 2 weeks.(3)In the respect of EEG find-ings,perfusion at 15~25℃and rate of 2.4 L/M~2/min was better than lower tem-perature and rate.