摘要
目的对深低温停循环(DHCA)前降温期行不同血气管理方法动物模型进行脑电图监测,探讨利于脑保护的体外循环血气管理方法.方法上海种白猪18头,年龄4～5周,体质量6～8kg.随机分为A组、P组、PA组,每组各6头.基础麻醉后监测鼻咽部温度.胸部正中切口,显露心脏按临床方法建立体外循环,分别按下述方法转流降温20 min至鼻咽温度18℃.A组用α-稳态血气管理;P组用pH-稳态血气管理;PA组前15min用pH稳态,后5min用α-稳态血气管理.停循环60min后各组均用α-稳态;灌注流量100 mL/(kg·min);灌注温度20～25℃复灌,5 min后复温至鼻咽温36℃.术中及降温期连续监测脑电图变化.结果脑电图监测示复温末P组脑电活动恢复最快,A组脑电活动无恢复.结论在实施DHCA的降温有限时间内,应用pH-或应用pH后用α稳态血气管理较用单纯α-稳态血气管理方法有更好的脑保护作用.
Objective To search for an optimal method of blood gas management on cerebral protection, to deteat monitor Electroencenphalograply（EEG） of brain function with different blood gas management during cooling before deep hypothermia circulatory arrest（PHCA）. Methods Eighteen piglets（age 4-5 weeks, weight 6-8kg）were randomly divided into 3 groups： group A （n=6）,group P（n=6）, group PA（n=6）. Temperature probes were placed in the nasopharynx after aninmals were anesthetized. The heart was exposed through a median stemotomy. The cardiopulmonary bypass was performed according to clinical methods. Aninmls were cooled to nasopharyngeal temperature（NPT）18℃ over 20 minutes as follows： group A received alpha-star strategy, group P received pH-star strategy, the group PA received pH-star strategy for 15 minutes followed by a switch to alpha-star strategy for the last 5 minutes of cooling. Perfusion was stopped for 60 minutes. Reperfusion was begun at 100 mL/（kg·min） with the perfusate at mona temperature（20-25℃） for 5 minutes initially with alpha-star strategy and then rewarmed to NPT 36℃ . EEGs were monitored continuously during the operation and the cooling period. Result The mean latency to recovery of EEG activity after the onset of reperfusion was the shortest in group P and the longest in group A. Conclusion As DHCA is performed, using pH-star or alpha-star after pH-stat-alpha star blood gas management is better than using alpha-star strategy for cerehral protection when cooling time is limited.
出处
《实用儿科临床杂志》
CAS
CSCD
北大核心
2005年第8期783-784,共2页
Journal of Applied Clinical Pediatrics
关键词
深低温停循环
血气
脑电图
deep hypothermia circulatory arrest
blood gas
electroencenphalography
