以脑氧饱和度监测为导向维护体外循环冠脉搭桥手术期间脑氧供需平衡

目的探讨脑氧饱和度(SctO2)监测在冠心病患者行体外循环冠脉搭桥术中反映脑氧供需平衡的临床应用价值。方法 10例冠心病冠脉搭桥术患者,美国麻醉师协会(ASA)II~III级,术中常规监测动脉压(MAP)、心率(HR)、脉搏血氧饱和度(SpO2)、呼气末二氧化碳分压(PetCO2)、脑电双频指数(BIS)、体温(T)、SctO2。术中以SctO2为导向进行脑氧供需平衡管理。结果体外循环期间,SctO2明显下降(P0.05),但高于基础值的75%,术后无认知功能障碍和严重神经系统并发症发生。结论体外循环冠脉搭桥术手术期间以SctO2为导向进行脑氧供需平衡管理,能够及时准确反映脑血流及氧供需平衡的变化,预防神经系统不良事件的发生。

Maintenance of cerebral oxygen balance by the guide of cerebral tissue oxygen saturation monitoring during coronary artery bypass grafting surgery.

Objective To investigate the value of cerebral tissue oxygen saturation （ SctO2 ） monitoring in clinical application for patients during coronary artery bypass grafting （CABG）. Methods Ten patients with coronary artery disease, ASA II - III, were scheduled for CABG. Blood pressure （BP） , heart rate （ HR）, pulse oxygen saturation （ SpO2 ）, end - tidal carbon dioxide partial pressure （ PetCO2 ）, bispectral index （BIS）, body temperature （T） and SctO2 were monitored and recorded intraoperatively. During the operation, cerebral oxygen supply and demand balance was maintained by the guide of SctO2. Results During cardiopulmonary bypass, there was significant decrease of SctO2 （ P 〈 0.05 ）, but SctO2 was not less than 75% of the basic value. There were no postoperative cognitive dysfunction or neurological complications after opera- tion. Conclusion SctO2 monitoring provides the real - time and accurate information of cerebral blood flow and cerebral oxygen balance and prevents neurological adverse events during CABG.