控制性降压期间脑组织血流及氧供需平衡状况的临床研究

目的 观察不同水平控制性降压时脑血流量及氧供需平衡状况。方法 将３０例临床择期手术患者随机分成３组,每组均为１０例。组１（Ｇ１）控制性降压”水平为平均动脉压（ＭＡＰ）５５ｍｍＨｇ,组２（Ｇ２）为６５ｍｍＨｇ,组３（Ｇ３）未施降压,作为对照。采用频率为２ＭＨｚ的经颅多普勒脑血流速度仪（ＴＣＤ）测定大脑中动脉血流速率,同时ｍｍＨｇ,维持１ｈ,上述两组脑组织血供及代谢指标与对照组间差异无显著意义。结论吸

The effects of sodium nitroprusside-induced hypotension at different levels on cerebral blood flow and metabolism: a clinical study

OBJECTIVE: The clinical experiment was designed for observing the effects of deliberate hypotension at different level on cerebral blood flow and metabolism. METHODS: 30 ASA Grade I-II patients were randomly allocated to one of three groups (each group n = 10). Hypotension was induced by sodium nitroprusside in group 1[mean arterial pressure (MAP) = 55 mmHg] and group 2 (MAP = 65 mmHg). Group 3 (control) was on normotension. The changes of cerebral blood flow during hypotension were estimated according to the variability of cerebral blood flow velocity (CBFV) in the middle cerebral artery(MCA), which was obtained through transcranial Doppler ultrasonography (TCD). RESULTS: Hypotension caused a moderate decrease in CBFV, but no significant difference, in CBFV and oxygen saturation in internal jugular vein(SjO2), either among three groups or during the procedure. CONCLUSIONS: It is safe for cerebral perfusion and metabolism with deliberate hypotension at MAP = 55 mmHg.