“寸口”脉搏波图在体外循环搏动灌注中的应用

Clinical research on pulsatile perfusion during cardiopulmonary bypass based on cunkou PW graph

目的:通过观察基于"寸口"脉搏波图监测的体外循环搏动灌注与非搏动灌注实验指标的变化,探索"寸口"脉搏波图作为体外循环搏动灌注质控指标的可行性。方法:选取35例搏动灌注病人及45例非搏动灌注病人,根据术中"寸口"脉搏波图调节体外循环机的参数,检测病人手术中超敏C反应蛋白、乳酸、尿量、尿隐血,手术后尿酸、心跳自复率、凝血酶原时间等指标,进行比较分析。结果:搏动灌注组术中乳酸明显低于非搏动灌注组,术中单位时间尿量增多,术后血尿酸下降,C反应蛋白较低,凝血酶原时间较短。术中尿隐血无显著差异但少于非搏动组,心跳自复率无明显差异但高于非搏动组。结论:①"寸口"脉搏波图能安全有效的监测体外循环搏动灌注。②"寸口"脉搏波图监测下的搏动灌注各项检测指标明显优于非搏动灌注组,更接近生理,能保护人体脏器功能。

Objective： To explore the establishment of quantitative indicators on Pulsatile perfusion during cardiopulmonary bypass Based on Cunkou PW graph, by observing the diversification of experimental indicators of pulsatile and nonpulsatile perfusion during cardiopulmonary bypass based on PW graph. Methods： Selecting Guan of right hand, we monitored the PW graph of 35 patients of pulsatile perfusion and 45 patients of nonpulatile perfuion with pulse instrument type of ZM-Ⅲc. To monitor the function of liver and kidney by urine volume, PT, CRP, etc. Results： ①There existed significant difference （P0.01） in CLAC during the operation. ②There existed significant difference （P0.01） in PT. ③There existed significant difference （P0.05） in CRP. ④There existed significant difference（P0.01）in urine volume. Conclusion： The protection of vital organs of the body function by pulsatile perfusion was useful. PW graph can be used as an effective quantitative indicator of pulsatile perfusion.