体外循环手术患者寸口脉搏波监测与分析

Monitor and analyze the sphygmograph of Cunkou in patient underwent cardiopulmonary bypass operation

目的通过体外循环不同灌注模式手术患者的寸口脉搏波分析与研究,探索建立基于寸口脉搏波监测的体外循环"搏动灌注"血流搏动波的量化分析方法。方法将34例行体外循环术的心脏疾病患者随机分为"搏动灌注"组和"非搏动灌注"组,每组各17例;观察手术者寸口脉搏波情况,比较"搏动灌注"手术者术前、"搏动灌注"过程中寸口脉搏波。结果体外循环手术者主动脉血流阻断后寸口未出现明显的脉搏波,"搏动灌注"开始后寸口出现脉搏波;"非搏动灌注"手术者在整个血液灌注过程中寸口未出现明显的脉搏波;"搏动灌注"手术者术前、"搏动灌注"时寸口均出现脉搏波,但"搏动灌注"时脉搏波较低平。结论初步的研究结果提示,寸口脉搏波能反映体外循环"搏动灌注"搏动能量的传递状况;寸口脉搏波可作为观察体外循环"搏动灌注"搏动能量传递效果的客观指标;脉搏波幅度、面积等参数可尝试作为观察"搏动灌注"效果的量化指标。

Objective To analyze the Cunkou sphygmograph of different perfusion modes under cardiopulmonary bypass and explore the way to establish the quantification methods of pulsatile perfusion during eardiopulmonary bypass based on sphygmograph analysis. Methods Thirty-four patients with heart diseases undergoing cardiopulmonalT bypass were randomized into pulsatile group and nonpulsatile group, 17 cases in each group. The Cunkou sphygmograph of pulsatile was observed, the pulatile perfusion during operation and preoperation of nonpulatile perfusion were compared. Results No obvious Cunkou sphygmograph waveform was found in patients during cardiopulmonaly bypass, and there was sphygmograph waveform after pulsatile peIfusion, but without after nonpulsatile perfusion. After pulsatile perfusion, there was sphygmograph waveform before and during pulsatile perfusion, however the main wave of pnlsatile perfusion was lower than preoperation. Conclusion The preliminary experimental results show that Cunkou sphygmograph can reflect the energy transfer of pulsatile perfusion during cardiopulmonary bypass. The waveform can be used as an objective index to observe the pulsatile energy transfer effect of pulsatile perfusion during cardiopulmonaly bypass ; sphygmograph amplitude and area parameters can be used as quantitative indexes to observe the effect of pulsatile perfusion.