主动脉弓部手术中温度变化对脑电阻抗的影响  

Effect of temperature changing on cerebral electrical impedance during aortic arch surgery

作　　者：胡志斌 毛文帅 郭李君 刘志伟 葛根贤 周冰 崔勇 Hu Zhibin;Mao Wenshuai;Guo Lijun;Liu Zhiwei;Ge Genxian;Zhou Bing;Cui Yong(Department of Cardiovascular Surgery,Heart Center,Zhejiang Provincial People's Hospital(Affiliated People's Hospital,Hangzhou Medical College),Zhejiang Hangzhou 310014,China)

机构地区：[1]杭州医学院附属人民医院(浙江省人民医院)心脏大血管外科,杭州310014

出　　处：《中国体外循环杂志》2023年第6期342-345,354,共5页Chinese Journal of Extracorporeal Circulation

基　　金：浙江省医药卫生科技计划项目(2022KY519);2021年浙江省医师协会临床研究基金项目(恒瑞麻醉专项)

摘　　要：目的研究深度降温、复温与人体脑电阻抗之间的关系,确定温度补偿脑电阻抗校正系数,为电阻抗断层成像技术应用于脑功能监测提供参考依据。方法2022年1月至2022年12月期间实施深低温停循环联合选择性顺行脑灌注技术行主动脉弓部手术患者32例,监测脑电阻抗,并实时记录鼻咽温度变化。观察降温与复温过程中脑电阻抗变化情况,利用SPSS统计软件分析两者的关系,并推导温度变化时脑电阻抗测量的校正因子。结果①脑电阻抗随着温度的降低而增大,随着温度的上升而减小,两者呈显著线性相关[降温过程r=(-0.992±0.008),P<0.05;复温过程r=(-0.991±0.009),P<0.05];②同一降温或复温过程中各例脑阻抗与温度关系的斜率无显著性差异,但降温与复温过程相比差异有统计学意义(t=3.545,P<0.05);③脑电阻抗变化幅度与变温速率无显著相关(降温过程r=-0.279,P=0.121;复温过程r=-0.329,P=0.066);④在降温与复温过程中脑阻抗变化幅度分别为1.856%/℃、1.760%/℃,平均1.808%/℃。结论脑阻抗与温度具有很强的线性相关关系;在低温状态下测量脑电阻抗时应修正温度变化影响,其校正因子为1.808%/℃。Objective The aim of this study was to define the relationship between temperature and cerebral electrical impedance(CEI),and to derive correction factors for adjustment of impedance measurements during hypothermia.Methods There were 32 patients undergoing aortic arch surgery by deep hypothermic circulatory arrest with selective antegrade cerebral perfusion during January 2022 to December 2022.All of them were monitored with CEI and nasopharyngeal temperature.Effect of cooling and re-warming on CEI were observed and analysed by the SPSS statistical software.Results 1.CEI was increasing with cooling and decreasing with re-warming.There was a strong linearly correlation between impedance and temperature for all temperatures measured(cooling:r=-0.992±0.008,P<0.05;re-warming:r=-0.991±0.009,P<0.05).2.The slope for the relationship between CEI and temperature was no significantly different during cooling or re-warming,but that was significantly different between cooling and re-warming(t=3.545,P<0.05).3.The magnitude of CEI changes observed was not significantly correlation with the rate of temperature changes(cooling:r=-0.279,P=0.121;re-warming:r=-0.329,P=0.066).4.The magnitude of CEI changes is about 1.856%with cooling by 1℃and about 1.760%with re-warming by 1℃.The average value was 1.808%/℃.Conclusions CEI was linearly related to temperature and it was the same during cooling and re-warming.The correction factors had been derived was 1.808%/℃and for adjustment of impedance measurements during hypothermia.

关 键 词：脑电阻抗 深低温停循环 体外循环 主动脉弓部手术 

分 类 号：R651.15[医药卫生—外科学]