异丙酚对体外循环期间脑氧供需平衡的影响

目的 :探讨异丙酚对体外循环期间脑氧供需平衡的影响。方法 :将 30例拟在体外循环 (CPB)下行瓣膜置换术的病人随机分为对照组和异丙酚组 ,对照组用芬太尼维持麻醉 ,异丙酚组则用异丙酚 ,观察两组病人颈静脉血氧饱和度 (SjO2 )、动脉和颈内静脉血氧含量差 (Da -vO2 )、脑氧摄取率 (CEO2 )的变化。结果 :复温时异丙酚组SjO2 显著高于对照组 ,Da -vO2 及CEO2 显著低于对照组 ,且复温时SjO2 与CPB前相比 ,差异无统计学意义 (P >0 .0 5 )。结论 :异丙酚能够防止CPB时脑氧供需失衡。护理上应充分做好术前准备 ,熟练配合手术 ,以缩短CPB及低温时间。

Affect of Isopropyl Phenol on the Cerebral Oxygen Supply-Demands Balance in Patients Underwent Cardiopulmonary Bypass

Objective: to explore the affect of isopropyl phenol on the cerebral oxygen supply-demands balance in patients underwent cardiopulmonary bypass(CPB). Methods: a total of 30 patients would undergo cardiac valve replacement under CPB were divided into both control and test group randomly. Patients of control group were given fentanyl to maintain their anesthesia. Patients of test group just gave isopropyl phenol. Changes of items including jugular venous blood oxygen saturation (SjO 2), jugular arterial-venous oxygen content difference (Da-vO 2) and cerebral oxygen extraction rate (CEO 2) of patients of the two groups were observed. Results: during rewarming period, SjO 2 of patients in test group was remarkably higher than that of patients in control group, but Da-vO 2 and CEO 2 of patients in test group was lower than that of patients in control group. However, there was no significant difference in terms of SjO 2 before and after CPB(P<0.05). Conclusion: isopropyl phenol could prevent the imbalance of cerebral oxygen supply and demand in patients undergoing CPB. Nurses should do well in preoperative preparation for these patients and coordinate skillfully to shorten both the duration of CPB and the time of hypothermia.