儿童与成人心内直视手术中脑电图及颈动脉血流的观察

在心内直视手术中，为了解儿童脑电图（ＥＥＧ）与成人的差异，观察了２０例儿童和成人术中ＥＥＧ及颈动脉血流变化。结果显示：成人组鼻温与ＥＥＧ波率、额部波幅和枕部波幅有较好相关性（Ｐ＜０．００１）。颈动脉血管直径及颈动脉平均流速与ＥＥＧ波幅呈负性相关（Ｐ＜０．０５），平均动脉压与ＥＥＧ亦有较好的相关性（Ｐ＜０．００５）。在儿童组同样有以上的相关现象。其相关性在儿童组较成人组为明显。提示儿童ＥＥＧ对外部环境的变化较为敏感，变异性较大，特别是在体外循环手术中有其自身的变化规律，受血液动力学及温度的双重影响，与成人有较大的差异，特别是在体外循环手术中尤为明显。

STUDIES ON ELECTROENCEPHALOGRAPHY AND CAROTID ARTERY BLOOD FLOW DURING OPEN HEART SURGERY IN CHILDREN AND ADULTS

To understand the electroencephalographic (EEG) difference between children and adult,EEG and carotid arterial blood flow of 20 cases with 10 children and 10 adults in each group were observed during open heart surgery under cardiopulmonary bypass(CPB)and hypothermia. In the adult group the temperature showed good positive correlation with the rate and amplitute of EEG waves in the frontal and occipital areas(p<0.001).It means that the activity of the central nervous system changes with the temperature during CPB. The carotid artery diameter and the mean velocity showed good negative correlation with the amplitute of the EEG wave(p<0.05),and the mean arterial pressure(MAP) correlated well with EEG(p<0.001),which demonstrates the profound effect of hemodynamics on brain function.Same results were found in the children group, but the correlations were more significant than in the adult group implying that the EEG in children is more sensitive to the environment with much more variability,especially in CPB influenced simultaneously by hemodynamic and temperature changes.So EEG and carotid arterial blood flow monitoring are clinically important for the brain function.