颈动脉手术的麻醉管理与脑保护

目的：探讨颈动脉手术的麻醉管理方法与脑保护效果。方法：37例颈动脉手术的病人，在全身麻醉的基础上采用局部低温及药物治疗综合实施脑保护，对其中12例病人以监测脑氧供需平衡的方法，评价综合脑保护措施的效果。结果：全组病人麻醉及脑保护效果满意，颈动脉阻断后的颈动－静脉血氧含量差和脑氧摄取率有增加趋势（P＞0．05），但颈动脉开放后，脑的颈动－静脉血氧含量差和脑氧摄取率比阻断前显著增加（P＜0．05），结论：在全身麻醉的基础上，局部低温及药物治疗等综合措施有一定的脑保护作用。但不能完全消除脑的缺血－再灌注损伤。

Anaesthesia management and cerebral protection during carotid artery surgery

Objective To study the anesthetic management and cerebral protection effects during carotid artery operation.Methods Cerebral protection was performed by using regional hypothermia and medicine in 37 patients underwent carotid artery operation under general anesthesia.In 12 of 37 patients,cerebral oxygen supply and oxygen consumption were monitored for evaluating the effects of the cerebral protection measures.Results The outcome of anesthesia and cerebral protection was all satisfied in 37 patients.At 15min after the carotid artery cross clamping,cerebral arterio venous oxygen difference had a tendency of increase ( P> 0 05),which was augmented significantly at 30min after release of carotid artery cross clamping compared with that prior to cross clamping ( P< 0 05).Conclusion Under general anaesthesia,regional hypothermia together with medicine has a certain effect on cerebral protection,but the cerebral ischemia reperfusion injury can not be avoided completely.