Objective To predict the tolerance of the brain to carotid occlusion using noninvasive methods.Methods The peak(pV) and mean blood flow velocity(mV) of middle cerebral artery (MCA) and anterior cerebralartery (ACA) an...Objective To predict the tolerance of the brain to carotid occlusion using noninvasive methods.Methods The peak(pV) and mean blood flow velocity(mV) of middle cerebral artery (MCA) and anterior cerebralartery (ACA) and pulsatility index (PI) were measured pre-and postoperatively with transcranial Dopplerultrasound diagnosis system(TCD) associated with the regional cerebral oxygen (rSO2) and somatosensory evokedpotentials (SSEPs) evaluation in 15 patients during manual compression, temporary occlusion and permanentocclusion Ol the carotid artery (CAO). Results There was no neurological delcit appearing during CAO in allthe cases. The mV of ipsilateral MCA and ACA reduced (31.79±13.59)% (12.58% ~56.16%) and reversed to 27.69±23.15cm/s and the rSO2 decreased (5.29±1.96)% (2%~9%). There was a linear correlation between percentchange in mV of ipsilateral MCA and rSO2 fall (P=0.0001). No more than 50% attenuation of SSEPs occurred inall the cases. The difference of PI in all recording time was not signilicant in our study. The pV was correlatedwith mV (P=0.0001). No variables were different significantly between compression and occlusion. Conclusion Afall in velocity by more than 70%, in rSO2 by more than 10% or in SSEPs amplitude by more than 50% iscompelling evidence for intolerance to CAO.展开更多
目的探讨不同心房颤动血栓危险度评分(CHA_(2)DS_(2)-VASc)患者行鼻内镜手术时MAP与局部脑氧饱合度(regional oxygen saturation,rSO_(2))的关系,及心房颤动患者rSO_(2)变化率与CHA_(2)DS_(2)-VASc评分的相关性。方法选择2019年1月至202...目的探讨不同心房颤动血栓危险度评分(CHA_(2)DS_(2)-VASc)患者行鼻内镜手术时MAP与局部脑氧饱合度(regional oxygen saturation,rSO_(2))的关系,及心房颤动患者rSO_(2)变化率与CHA_(2)DS_(2)-VASc评分的相关性。方法选择2019年1月至2020年12月首都医科大学附属北京同仁医院择期行全身麻醉鼻内镜手术的心房颤动患者,美国麻醉医师协会(American Society of Anesthesiologists,ASA)分级Ⅱ~Ⅲ级,性别不限,年龄>18岁,根据CHA_(2)DS_(2)-VASc分为低危组(L组,CHA_(2)DS_(2)-VASc≤2分)和高危组(H组,CHA_(2)DS_(2)-VASc≥3分)。分别于麻醉诱导前3 min(T_(0))、MAP较T_(0)降低10%(T_(1))和20%(T_(2))时,记录患者rSO_(2)和rSO_(2)变化率(ΔrSO_(2)%)。结果共纳入患者23例,L组13例,H组10例。与L组比较,H组年龄更大[(80.0±4.0)岁比(63.0±6.0)岁],T_(0)时MAP更高[(108.4±8.0)mm Hg比(88.4±11.2)mm Hg,1 mm Hg=0.133 k Pa],T_(2)时rSO_(2)更低[(61.2±3.8)%比(64.5±2.6)%],差异均有统计学意义(P<0.05)。T_(2)时,两组术前CHA_(2)DS_(2)-VASc与ΔrSO_(2)%呈中度负相关(r=-0.495,P<0.05)。结论心房颤动患者行全身麻醉鼻内镜手术,当MAP降低超过20%时,术前CHA_(2)DS_(2)-VASc越高,术中rSO_(2)下降的幅度越大。展开更多
文摘Objective To predict the tolerance of the brain to carotid occlusion using noninvasive methods.Methods The peak(pV) and mean blood flow velocity(mV) of middle cerebral artery (MCA) and anterior cerebralartery (ACA) and pulsatility index (PI) were measured pre-and postoperatively with transcranial Dopplerultrasound diagnosis system(TCD) associated with the regional cerebral oxygen (rSO2) and somatosensory evokedpotentials (SSEPs) evaluation in 15 patients during manual compression, temporary occlusion and permanentocclusion Ol the carotid artery (CAO). Results There was no neurological delcit appearing during CAO in allthe cases. The mV of ipsilateral MCA and ACA reduced (31.79±13.59)% (12.58% ~56.16%) and reversed to 27.69±23.15cm/s and the rSO2 decreased (5.29±1.96)% (2%~9%). There was a linear correlation between percentchange in mV of ipsilateral MCA and rSO2 fall (P=0.0001). No more than 50% attenuation of SSEPs occurred inall the cases. The difference of PI in all recording time was not signilicant in our study. The pV was correlatedwith mV (P=0.0001). No variables were different significantly between compression and occlusion. Conclusion Afall in velocity by more than 70%, in rSO2 by more than 10% or in SSEPs amplitude by more than 50% iscompelling evidence for intolerance to CAO.
文摘目的探讨不同心房颤动血栓危险度评分(CHA_(2)DS_(2)-VASc)患者行鼻内镜手术时MAP与局部脑氧饱合度(regional oxygen saturation,rSO_(2))的关系,及心房颤动患者rSO_(2)变化率与CHA_(2)DS_(2)-VASc评分的相关性。方法选择2019年1月至2020年12月首都医科大学附属北京同仁医院择期行全身麻醉鼻内镜手术的心房颤动患者,美国麻醉医师协会(American Society of Anesthesiologists,ASA)分级Ⅱ~Ⅲ级,性别不限,年龄>18岁,根据CHA_(2)DS_(2)-VASc分为低危组(L组,CHA_(2)DS_(2)-VASc≤2分)和高危组(H组,CHA_(2)DS_(2)-VASc≥3分)。分别于麻醉诱导前3 min(T_(0))、MAP较T_(0)降低10%(T_(1))和20%(T_(2))时,记录患者rSO_(2)和rSO_(2)变化率(ΔrSO_(2)%)。结果共纳入患者23例,L组13例,H组10例。与L组比较,H组年龄更大[(80.0±4.0)岁比(63.0±6.0)岁],T_(0)时MAP更高[(108.4±8.0)mm Hg比(88.4±11.2)mm Hg,1 mm Hg=0.133 k Pa],T_(2)时rSO_(2)更低[(61.2±3.8)%比(64.5±2.6)%],差异均有统计学意义(P<0.05)。T_(2)时,两组术前CHA_(2)DS_(2)-VASc与ΔrSO_(2)%呈中度负相关(r=-0.495,P<0.05)。结论心房颤动患者行全身麻醉鼻内镜手术,当MAP降低超过20%时,术前CHA_(2)DS_(2)-VASc越高,术中rSO_(2)下降的幅度越大。
