In the preoperative management of congenital heart disease (CHD) with increased pulmonary blood flow, hypoxic gas management to control pulmonary blood flow is useful. However, the cerebral oxygenation state has rarel...In the preoperative management of congenital heart disease (CHD) with increased pulmonary blood flow, hypoxic gas management to control pulmonary blood flow is useful. However, the cerebral oxygenation state has rarely been studied, and there is concern about neurologic development. In eight infants with CHD accompanied by increased pulmonary blood flow,hypoxia was induced after a 1-h baseline period in room air (FiO2, 0.21). The infants were simultaneously monitored in both the fronttemporal region and the right-brachial region for 90 min using near-infrared spectroscopy (NIRS). The minimum SaO2 (pulse oximetry) after hypoxic gas administration was 80.8 ± 2.9% when the minimum FiO2 was 16.2 ± 1.1% . With a decrease in SaO2, oxy-Hb (O2Hb) decreased and total Hb cHb: O2Hb + deoxy-Hb (HHb) increased in both regions in the majority of infants. HHb increased in both regions with a decrease in SaO2. The maximum change in the tissue oxygenation index (TOI:O2Hb/cHb × 100) was -8.3 ± 2.6% in the front-temporal region and -3.6 ± 2.3% in the right-brachial region. Cerebral oxygenation decreased despite an increase in cerebral blood flow during hypoxic gas management. The change in TOI was ≤ 10% when the SaO2 was ≥ 80% . Safer control of SaO2 should be maintained over 80% for hypoxia management in CHD based on the results of the present study.展开更多
目的探讨动态监测脑血流及脑氧饱和度对预防沙滩椅位肩关节镜手术后缺血性脑损伤的临床效果。方法选取2014年5月~2016年8月在深圳市第二人民医院进行沙滩椅位肩关节镜手术患者48例作为研究对象,按照简单随机法将患者分为对照组和观察组...目的探讨动态监测脑血流及脑氧饱和度对预防沙滩椅位肩关节镜手术后缺血性脑损伤的临床效果。方法选取2014年5月~2016年8月在深圳市第二人民医院进行沙滩椅位肩关节镜手术患者48例作为研究对象,按照简单随机法将患者分为对照组和观察组,每组各24例。对照组术中监测指端血压及氧饱和度,观察组术中监测脑血压及脑氧饱和度。比较两组患者手术情况、术后7 d ULCA评分、血压及血氧饱和度变化、术后简易精神状态量表(MMSE)评分。结果两组患者手术时间、术中出血量、术后引流量及术后拔管时间差异无统计学意义(P>0.05)。观察组患者术后7 d ULCA评分优良率(87.50%)与对照组(91.67%)差异无统计学意义(P>0.05)。两组患者术后血压及血氧饱和度均明显下降,差异有统计学意义(P<0.05);观察组患者术后血压及血氧饱和度均高于对照组,差异有统计学意义(P<0.05)。两组患者术后MMSE评分均有下降,但是观察组患者MMSE评分明显高于对照组,差异有统计学意义(P<0.05)。结论进行沙滩椅位肩关节镜手术时,动态检测脑血流及脑氧饱和度,可有效降低缺血脑损伤的发生风险,提高患者术后恢复。展开更多
文摘In the preoperative management of congenital heart disease (CHD) with increased pulmonary blood flow, hypoxic gas management to control pulmonary blood flow is useful. However, the cerebral oxygenation state has rarely been studied, and there is concern about neurologic development. In eight infants with CHD accompanied by increased pulmonary blood flow,hypoxia was induced after a 1-h baseline period in room air (FiO2, 0.21). The infants were simultaneously monitored in both the fronttemporal region and the right-brachial region for 90 min using near-infrared spectroscopy (NIRS). The minimum SaO2 (pulse oximetry) after hypoxic gas administration was 80.8 ± 2.9% when the minimum FiO2 was 16.2 ± 1.1% . With a decrease in SaO2, oxy-Hb (O2Hb) decreased and total Hb cHb: O2Hb + deoxy-Hb (HHb) increased in both regions in the majority of infants. HHb increased in both regions with a decrease in SaO2. The maximum change in the tissue oxygenation index (TOI:O2Hb/cHb × 100) was -8.3 ± 2.6% in the front-temporal region and -3.6 ± 2.3% in the right-brachial region. Cerebral oxygenation decreased despite an increase in cerebral blood flow during hypoxic gas management. The change in TOI was ≤ 10% when the SaO2 was ≥ 80% . Safer control of SaO2 should be maintained over 80% for hypoxia management in CHD based on the results of the present study.
文摘目的探讨动态监测脑血流及脑氧饱和度对预防沙滩椅位肩关节镜手术后缺血性脑损伤的临床效果。方法选取2014年5月~2016年8月在深圳市第二人民医院进行沙滩椅位肩关节镜手术患者48例作为研究对象,按照简单随机法将患者分为对照组和观察组,每组各24例。对照组术中监测指端血压及氧饱和度,观察组术中监测脑血压及脑氧饱和度。比较两组患者手术情况、术后7 d ULCA评分、血压及血氧饱和度变化、术后简易精神状态量表(MMSE)评分。结果两组患者手术时间、术中出血量、术后引流量及术后拔管时间差异无统计学意义(P>0.05)。观察组患者术后7 d ULCA评分优良率(87.50%)与对照组(91.67%)差异无统计学意义(P>0.05)。两组患者术后血压及血氧饱和度均明显下降,差异有统计学意义(P<0.05);观察组患者术后血压及血氧饱和度均高于对照组,差异有统计学意义(P<0.05)。两组患者术后MMSE评分均有下降,但是观察组患者MMSE评分明显高于对照组,差异有统计学意义(P<0.05)。结论进行沙滩椅位肩关节镜手术时,动态检测脑血流及脑氧饱和度,可有效降低缺血脑损伤的发生风险,提高患者术后恢复。
