摘要
目的 观察异丙酚对中低温体外循环心肺转流术 (CPB)期间脑氧合的影响。方法 心内直视手术患者 17例随机分为芬太尼组和异丙酚组 ,通过监测动脉、颈内静脉血和混合静脉血氧含量以及乳酸浓度 ,计算全身和脑动静脉氧含量差、氧摄取率和动静脉乳酸浓度差 ,分析异丙酚对CPB期间脑氧合的影响。结果 两组复温过程中动静脉氧含量差和氧摄取率均较低温时升高 ;异丙酚组在CPB过程中动脉 颈内静脉血氧含量差和脑的氧摄取率要高于芬太尼组 (P <0 0 5 ) ,动脉 混合静脉血氧含量差和全身的氧摄取率两组差异无显著意义 (P >0 0 5 )。CPB全过程中两组血乳酸浓度均进行性升高。结论 CPB期间应用异丙酚麻醉并不能明显改善脑氧合。CPB期间脑保护机理有其复杂性一面 。
Objective To observe the effects of propofol on cerebral oxygenation during hypothermia cardiopulmonary bypass(CPB).Methods Seventeen patients undergoing heart surgery were randomly divided in two groups:fentanyl group and propofol group.The oxygen content and the concentration of blood plasma lactic acid of artery,jugular venous bulb and pulmonary artery were monitored in the patients undergoing heart valve replacement at different nasopharyngeal temperatures.The arterial-venous oxygen content difference,oxygen extraction rate of cerebrum and total body were calculated.Results In two groups,arterial-venous differences and oxygen extraction rates during rewarming were both higher than those during hypothermia period.In propofol group,arterial-jugular venous difference and oxygen extraction were higher than those in fentanyl group(P<0.05) during CPB at the same time points.The differences between arterial-systemic venous differences and the oxygen extraction rates of total body in two groups were not significant(P>0.05).The concentration of lactic acid in plasm was increased in both groups during CPB.Conclusion Propofol cannot ameliorate cerebral oxygenation imbalance during CPB,especially during rewarming period.Cerebral protection involves many aspects including the improvement in the balance of oxygen delivery and consumption.
出处
《临床麻醉学杂志》
CAS
CSCD
2001年第4期180-183,共4页
Journal of Clinical Anesthesiology
