体外循环中微循环指标的临床研究

Study on Clinical Microcirculation Indexes during Infant Open Heart Surgery

目的探讨临床微循环指标在小儿体外循环(CPB)心脏直视手术中的应用及其意义。方法统计分析36例小儿法洛氏四联症CPB下心脏直视矫治术中的平均动脉压、中心静脉压、尿量、心肌色泽、心肌张力、自动复跳率、心电图、眼结膜微循环及指端温度、色泽。结果平均动脉压和尿量与肾微循环灌注呈正相关;心电图、心肌色泽、张力、心脏自动复跳率、平均动脉压可反映心脏微循环状态;眼结膜微循环及平均动脉压可观察脑微循环改变;中心静脉压仅反映血容量和右心功能。结论临床微循环指标为小儿复杂先天性心脏病矫治术提供了可靠的观察依据。

OBJECTIVE To study the clinical meanings of microcirculation indexes during infant open heart surgery. METHODS 36 cases of tetralogy of Fallot infants underwent sungery were studied. Retrospective analysis of following microcirculation indexes: the mean arterial blood pressure( MAP) , central venous pressure(CVP) , the volume of urine, the colour and tone of myocardium, the rate of spontaneous, return of heartbeat electrocardiogram(ECG) , the microcirculation of phthisis bulbi and fingertip. RESULTS MAP and the volume of urine is positive - relatived with the micro-circulation perfusion of the kidney; ECG,the colour and tone of myocardium, the rate of spontaneous return of heartbeat, MAP can reflect the states of myocardial microcirculation; from the microcirculation of phthisis bulbi and MAP indexes, we can observe the microcirculation changes of the brain; and CVP reflects the volume of blood and the function of right heart. CONCLUSION The clinical microcirculation indexes provide a reliable and objective basis in rectifying the infants with complex congenital heart disease.