摘要
目的初步探讨在小儿体外循环(CPB)过程中应用经颅多普勒(TCD)进行脑血流监测的可行性及其意义。方法对13例室间隔缺损(VSD)修补术患儿进行多时间点采样检测,并在CPB开始到主动脉阻断及主动脉开放到停CPB两个时间段进行持续监测,直观地显示CPB过程中的脑血流参数变化及频谱变化。结果以麻醉诱导后的脑血流频谱为对照,CPB开始、主动脉阻断、转流15 min、主动脉开放各时间段平均脑血流速度(CBFVm)均有明显下降(P<0.05、P<0.01、P<0.01、P<0.05),而CPB过程中各时间段比较无明显差异。单独比较麻醉诱导和关胸结束,CBFVm无明显差异(P=0.3652),CPB后血管脉动指数(PI)明显增高(P=0.0112)。结论TCD安全、简便、直观,可实时监测CPB过程中的脑血流参数变化及频谱变化,较准确地反映CPB过程中的脑灌注情况。
OBJECTIVE To explore the feasibility and significance of transcranial doppler（TCD） to monitor the cerebral blood flow velocity （CBFV） pattern during pediatric cardiopulmonary bypass （CPB）. METHODS The CBFV was measured in 13 children with ventricular septal defect（VSD） at several time -points during CPB. Continuous monitoring was used to display the characteristic CBFV pattern intuitively in the period from the start of CPB to aorta clamping on and the period from aorta clamping off to the termination of CPB. RESULTS Comparing to the CBFV pattern after induction of anesthesia, the mean CBFV was decreased significantly at the start of CPB, aorta clamping, during the CPB, aorta clamping off ,at the termination of CPB（ P 〈0.05, P 〈0.01, P 〈0.01, P 〈0.05）, whereas there was no difference observed during all the phase of CPB. In comparison with the values after induction of anesthesia, the CPFV was no significantly changed at the end of operation. CONCLUSION TCD can directly detect the real - time change of the CBFV pattern and determine critical cerebral perfusion with safety and convenience.
出处
《中国体外循环杂志》
2009年第3期132-134,F0003,共4页
Chinese Journal of Extracorporeal Circulation
关键词
经颅多普勒
体外循环
脑血流
室间隔缺损
Transcranial Doppler
Cardiopulmonary bypass
Cerebral blood flow
Ventricular septal defect
