丙酚与咪唑安定对体外循环期脑氧供需平衡的影响

30例瓣膜置换术病人随机分为对照组 (Ⅰ组 )、异丙酚组 (Ⅱ组 )和咪唑安定组 (Ⅲ组 ) ,观察体外循环(CPB)期颈静脉血氧饱和度 (SjO2 )、动脉、颈内静脉血氧含量差 (Da vO2 )、脑氧摄取率 (CEO2 )的变化。结果表明 :复温时Ⅱ ,Ⅲ组SjO2 显著高于Ⅰ组 ,Da vO2 及CEO2 显著低于Ⅰ组 (P <0 .0 1,P <0 .0 5 ) ,且复温时SjO2 与CPB前相比差异无显著性。提示异丙酚与咪唑安定均能防止CPB时脑氧供需失衡。

Effect of propofol and midazolam on cerebral oxygen supply and demand imbalance during cardiopulmonary bypass

Thirty patients undergoing heart valve replacement were divided randomly into three groups(n=10): control group, propofol group and midazolam group. Jugular bulb blood oxygen saturation(SjO 2),arterialvenous oxygen content difference(Da vO 2) and cerebral oxygen extraction rate(CEO 2) were measured at various periods of cardiopulmonary bypass(CPB). The results showed: SjO 2 decreased significantly, Da vO 2 and CEO 2 increased markedly during rewarming period in control group; but in propofol group and midazolam group, SjO 2, CEO 2 and Da vO 2 did not decline significantly compared with baseline. It is suggested that administering propofol or midazolam is helpful in avoiding cerebral oxygen supply and demand imbalance during CPB.