颈动脉内膜剥脱术对脑血液流变学及红细胞变形能力的影响

Effect of two different CEA on brain erythrocyte deformability and rheology

目的 探讨转流与无转流两种颈动脉内膜剥脱术 (CEA)术式对脑局部血液流变学及红细胞变形能力的影响。方法 选择择期行CEA手术的患者 2 2例 ,随机分为 2组 ,无转流组及转流组 ,每组 1 1例。 2组患者均在术前于术侧行颈内静脉逆行中心静脉插管 ,放射线下确认插管位于球部位置 ,分别于夹闭前后抽取颈静脉血进行流变学检查。术中监测ECG、HR、MAP、DP、SP、SPO2 、PETCO2 以及异氟醚吸入浓度。术中并行动脉血气分析。结果 CEA的体外动脉转流术式有利于保持血液流变学的稳定性 ,使红细胞流动性趋于稳定 ,保证红细胞变形能力。结论 脑缺血患者行CEA手术 ,体外动脉转流术式术中血液流变学及红细胞变形能力稳定 。

Objective To investigate the effect of two different CEA on brain erythrocyte deformability and rheology.Methods 22 patients treated with carotid endoarterectomy (CEA) operation were randomly divided into two groups(n=11):non-bypass and bypass.The analysis of erythrocyte deformability and rheology would be drawn at two different time points-before clamp and after clamp from the central venous cannulation which was done before operation and was affirmed under radiation.ECG?HR?MAP?DP?SP?SPO 2?P ET CO 2 and concentration of isoflurane were continuously monitored during operation.Conclusions Based on the results of erythrocyte deformability and rheology analysis, bypass operation of CEA was superior to non-bypass operation.