常温不停跳冠状动脉搭桥术对机体氧供需的影响

Effects of off-pump coronary artery bypass grafting on the balance of oxygen delivery and consumption

目的 研究常温心脏不停跳冠状动脉搭桥术对机体氧供需平衡的影响。方法 16例冠心病患者 ,在咪唑安定、芬太尼、丙泊酚、维库溴铵及异氟醚静吸复合麻醉下 ,心脏不停跳行冠状动脉搭桥手术。术中监测ECG、SpO2 及血液动力学指标。于冠脉血管吻合前后 ,分别取桡动脉及肺动脉血 ,测定血红蛋白 (Hb)和动脉血氧饱和度 (SaO2 ) ,并计算全身氧供需平衡。结果 冠状动脉搭桥前后CaO2 、C vO2 、DO2 、 VO2 、O2 ER、A aDO2 等均无明显变化 (P >0 0 5 ) ,CO搭桥后比搭桥前增加 ,但无显著性差异。

Objective To study the effects of off-pump coronary artery bypass grafting(CABG)on the balance of oxygen delivery and consumption.Methods 16 patients with coronary artery disease were undergoing off-pump CABG under intravenous-inhalation anesthesia with midazolan,fentanyl,propofol,vecuronium and isoflurane.ECG,SpO 2 and hemodynamics were monitored during surgery.The blood was sampled from radial and pulmonary artery before and after CABG for the measure ments of Hb and SaO 2 and calculation of the systematic oxygen delivery and consumption.Results CaO 2,CO 2,DO 2,O 2,O 2ER and A-aDO 2 had no significant changes before and after CABG (P<0.05).CO was increased after CABG nonsignificantly.Conclusion Off-pump CABG has less effects on the balances of oxygen delivery and consumption.