深低温低流量灌注心脏直视手术中的脑干听觉诱发电位变化

BAEP CHANGES DURING DEEP HYPOTHERMIC LOW-FLOW INTRACARDIAC OPERATION

为了解心脏直视手术时深低温低流量灌注对脑功能的影响，对６例复杂型先天性心脏病患儿在手术时进行了脑干听觉诱发电位（ＢＡＥＰ）监测。结果显示：（１）ＢＡＥＰ的各波峰和峰间潜伏期在体外循环前均正常；（２）肛温降至３５℃～２５℃以下ＢＡＥＰ波形全部消失；（３）流量恢复后在升温过程中Ｖ波首先复出；（４）肛温恢复３５℃时波形恢复至深低温低流量灌注前，在体外循环前后ＢＡＥＰ的波峰和各峰间潜伏其无明显差异（Ｐ＞０．０５）。本文结果提示：深低温低流量灌注过程对病儿的听神经。脑干中枢通路无明显损害，可作为心脏直视手术期间的脑监护手段。

n order to evaluate the impact of deep hypothermic and low-flow cardiopulmonary by-pass(CPB) on brain function,the brainstem auditory evoked potential(BAEP)was moni-tored in 6 patients with complicated congenital heart diseases during deep hypothermic low-flow intracardiac operation deep hypothermic. The results showed:(1) the peak levels andthe interpeak latencies of BAEP were normal in all patients before CPB;(2 )all wave ofBAEP disappeared at rectal temperature range from 35℃ to 25℃;(3)wave V reapeared ear-liestly after returning of flow rate during rewarming;(4)BAEP restored at rectal tempera-ture of 35℃ during rewarming,there were no significant difference in the peak levels and in-terpeak of BAEP latencies between pre-and post-CPB,The results suggest that deep hy-pothermic,low-flow intracardiac operation is not obviously harmful to the auditory pathwayof the brainstem,and the BAEP may be used for brain-monitoring during open heartSurgery.