摘要
目的探讨不同PETCO2对室间隔缺损修补术患儿脑氧合及脑血流的影响。方法择期行室间隔缺损修补术患儿60例,随机分为两组,每组30例。低通气组(L组):调控VT和RR,以维持PETCO2在40~45 mmHg;高通气组(H组):调控VT和RR,以维持PETCO2在35~40 mmHg。记录麻醉诱导后(T0)、开心包(T1)、CPB结束(T2)、改良超滤结束(T3)、术毕(T4)时的局部脑氧饱和度(rScO2)以及右侧大脑中动脉血流平均速度(VMCA)、搏动指数(PI)和阻力指数(RI)。结果与T2时比较,T0、T1、T3、T4时两组患儿rScO2和VMCA明显升高(P<0.05),PI和RI明显降低(P<0.05)。T0、T1、T3、T4时L组rScO2和VMCA明显高于H组(P<0.05)。结论PETCO2在40~45 mmHg时,患儿rScO2和VMCA高于PETCO2在35~40 mmHg时,可改善脑氧供需平衡。
Objective To analyze the change of different PETCO2 on regional cerebral oxygen saturation(rScO2) and cerebral blood flow in infants with ventricular septal defect repair. Methods In this study, 60 infants with VSD were randomly divided into high ventilation group(group H, 30 cases) and low ventilation group(group L, 30 cases). PETCO2 was maintained at 40-45 mmHg by regulating VT and RR in group L. PETCO2 was maintained at 35-40 mmHg by regulating VT and RR in group H. The values of rScO2, flow velocity of middle cerebral artery(VMCA) at the right side, pulse index(PI) and resistance index(RI) were recorded respectively after anesthesia(T0), cut pericardium(T1), the end of CPB(T2), the end of modified ultrafiltration(T3), after operation(T4). Results Compared with T2, the values of rScO2 and VMCA were significantly increased while the levels of PI and RI were decreased at T0, T1, T3, T4 (P<0.05). Meanwhile, the levels of rScO2 and VMCA in group L were higher than those in group H(P<0.05). Conclusion The infants’ rScO2 and VMCA performed better when PETCO2 is 40-45 mmHg versus 35-40 mmHg, which could improve the balance of cerebral oxygen supply and demand.
作者
崔博群
谢思远
马骏
欧阳川
CUI Boqun;XIE Siyuan;AM Jun;OUYANG chuan(Department of Anesthesiology, Beijing Anzhen Hospital, Capital Medical University,Beijing 100029, China)
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2019年第5期425-427,共3页
Journal of Clinical Anesthesiology
关键词
区域脑氧饱和度
脑血流
呼末二氧化碳
先天性心脏病
Regional cerebral oxygen saturation
Cerebral blood flow
End-tidal carbon dioxide partial pressure
Congenital heart disease
