犬低温体外循环综合监测的试验研究

STUDIES ON COMPREHENSIVE MONITORING FOR HYPOTHERMIC CARDIOPULMONARY BYPASS (CPB) IN THE CANINE

试验借助现代医学监测设备，首次在我国兽医临床对２８只低温体外循环的犬系统开展了生命体征综合监测的研究。结果表明，密切观察动态心电（ＥＣＧ），结合平均动脉压（ＭＡＰ）、中心静脉压（ＣＶＰ）、心率（ＨＲ）的变化，是判断循环功能、冠状动脉灌注、心肌缺血改变、保证脑血流通畅以及辅助转流时间长短的主要参考指标。保持良好的血气监测水平，是达到满意组织灌注不可缺少的指标；进一步证实，体外循环期维持良好的血钾水平，并于主动脉开放后１０ｍｉｎ适时补钙，有利于心脏收缩与复苏，对减轻心肌再灌注损伤具有重要作用。研究提示为确保每只手术犬在低温体外循环的肝素标准化以及合理使用鱼精蛋白用量，激活全血凝固时间（ＡＣＴ）的监测必须个体化。

In a series of experimantal studies, the changes of twenty-eight dogs′ life characteristics for Hypothermic CPB have been observed with modern monitoring equiments The parameters monitored include: Electorcardiogram (ECG), Heart Rate (HR), Mean Arterial Pressure (MAP), Central Venous Pressure (CVP) Body Temperature, Arteria blood gases (pH、PO 2 、PCO 2 、HCO - 3 、TCO 2 、ABE、SaO 2 ), electrolyte (K + 、Na + 、Ca ++ 、Cl - ,Urine folw, and Activated clotting Time (ACT) The conclusions could be drawn as follows: The ECG display, combined with monitoring of MAP、CVP and HR, indcate the circulative function, adquate coronary perfusion, mycardial ischaemia, brain vascularity and continuous CPB time Arteria blood gas is to be served as indicator of adequate tissue perfusion It is important that the levels of K + be maintained, and prompt calcium supplyment be cheson for myocardial systole, recovery and decrease repurfusion injury In order to assure heparin normalization and use the doses of protamine, ACT must be monitored for every experimental dog during CPB