摘要
目的研究心脏瓣膜病体外循环术中流量大小对酸碱度,尿量以及脑氧饱和度的影响,确定合适的灌注流量。方法选择40例心脏瓣膜病患者,分为高流量组(20例)和低流量组(20例)。比较两组患者麻醉诱导后(T_1),体外循环开始(T_2),主动脉阻断5 min(T_3),恢复温度5 min(T_4),主动脉开放5min(T_5)体外循环结束5 min(T_6)6个时间点的脑氧饱和度数值并记录T_1,T_3,T_4,T_54个时点的乳酸,BE数值及尿量。结果体外循环开始T_2点的脑氧饱和度略低于麻醉诱导后T_1点。T_4点脑氧饱和度略高于T_3点,乳酸值、BE绝对值略低于T_3。T_5点的脑氧饱和度高于T_4点乳酸值、BE绝对值低于T_4点。高流量组在T_3、T_4、T_5点的脑氧饱和度高于低流量组;而乳酸值和BE绝对值低于低流量组。结论高流量组可以增高脑氧饱和度降低血液乳酸,维持平衡的酸碱度,增加肾脏血流灌注。
Objective To investigate the effect of flow rate on pH, urine volume and cerebral oxygen saturation during cardiopulmonary bypass （CPB） in patients with valvular heart disease. Methods 40 with valvular heart disease were divided into the high flow group （n = 20） and the low flow group （n = 20）. The cerebral oxygen saturation value, lactic acid, BE value and the amount of urine between the two groups after induction of anesthesia （T,） , at the beginning of CPB （T2） , 5 min after declamping shock （T3）, 5 rain after recovery temperature （ T4 ） , 5 rain after aortic opening （ T5 ） , 5 rain after the end of aortic bypass （ T6 ） were compared. Results （ 1 ） The cerebral oxygen saturation at the beginning of T2 was slightly lower than that of T1 after anesthesia induction. （ 2 ） The cerebral oxygen saturation was slightly higher and the absolute value of lactic acid and BE was slightly lower at T4 than that of T3. （ 3 ） The cerebral oxygen saturation was higher and the absolute value of BE was lower at T5 than that of T4. （4） The eerebral oxygen satm＇ation of high flow group at T3, T4 and T5 was higher than that of the low flow group, while the absolute value of lactic acid and BE was lower than that of the low flow group. Conclusion High flow rate can increase cerebral oxygen satm＇ation, reduce blood lactic acid, maintain the balance of pH, and increase renal blood perfusion.
出处
《实用医学杂志》
CAS
北大核心
2017年第22期3792-3794,共3页
The Journal of Practical Medicine
关键词
心脏瓣膜病
体外循环
灌注流量
valvular heart disease
eardiopulmonary bypass
perfusion flow
