体外循环期间脑氧供需情况的观察

Cerebral Oxygen Delivery and Consumption during Cardiopulmonary Bypass

目的与方法 :通过对 2 0例心脏瓣膜置换术患者在体外循环心肺转流 (CPB)手术中行动脉和颈内静脉血气监测 ,以了解CPB期间脑氧供需情况。结果 :(1)降温期颈内静脉血氧饱和度 (SjvO2 )和脑血流量 /脑氧耗代谢比(CBF/CMRO2 )明显增加 ,由 6 6 2 4%± 10 32 % ,17 91± 3 0 4增至 93 81± 3 86 % ;139 2 8± 13 2 5。 (2 )复温期SjvO2和CBF/CMRO2 明显回落 ,分别降至 70 2 3%± 6 2 9% ,2 1 44± 9 6 8。 (3)CBF/CMRO2 与鼻咽部温度 (NPT)呈负相关 ,r =- 0 789。结论 :CPB中降温期可产生灌注过剩 。

Objective and Methods:To observe the cerebral metabolism of oxygen during CPB,we monitor the artery and jugular venous blood gas in 20 patients undergoing valve replacement.Results:(1)SjvO 2 and CBF/CMRO 2 increased significantly during hypothermia from 66 24%±10 32% to 93 81%±3 86% and 17 91±3 04 to 139 28±13 25 respectively.(2) SjvO 2 and CBF/CMRO 2 decreased significantly during rewarming period.The average values were 70 23%±6 29% and 21 44±9 68 respectively.(3)There was a significant relationship between CBF/CMRO 2 and NPT, r= -0 789.Conclusion:Monitoring of artery and jugular venous blood gas during CPB can give actural information that cerebral luxury perfusion might occur during hypothermia period and cerebral hypoperfusion might occur during rewarming period.