异丙酚防止体外循环复温期脑氧供需失衡  

Protective Effect of Propofol on the Imbalance between Cerebral Oxygen Supply and Demand duing Rewarming Period of Cardiopulmonary Bypass

作　　者：陈爱武[1] 陈艳平[1] 李李[1] 常业恬[1] 

机构地区：[1]湖南医科大学附属第二医院麻醉教研室,长沙市410011

出　　处：《临床麻醉学杂志》1999年第5期258-259,共2页Journal of Clinical Anesthesiology

基　　金：湖南省科委资助!项目(编号 :0 1 952 80 3)

摘　　要：目的 :观察CPB复温期使用异丙酚对颈静脉血氧饱和度 (SjO2 )的影响。方法 :2 2例瓣膜置换术病人随机分为两组。异丙酚组 12例 (Ⅰ组 ) ,复温开始时至CPB结束 15分钟以异丙酚 4～ 6mg·kg-1·h-1持续静脉泵入 ;对照组 10例 (Ⅱ组 ) ,不用异丙酚。观察两组病人CPB前、CPB后 5分钟、低温稳定期、复温至鼻咽温 (NPT) 3 4℃及停CPB后 5分钟及 15分钟时SjO2 变化。结果 :异丙酚组复温至NPT3 4℃及停CPB后 5分钟时SjO2 显著高于对照组 (P <0 0 1,P <0 0 5 ) ,脑氧摄取率显著低于对照组 (P <0 0 1,P <0 0 5 ) ,且异丙酚组复温至NPT3 4℃及停CPB后 5分钟与CPB前、后比较均无显著降低。结论 :体外循环复温期应用异丙酚可防止SjO2 降低。Objective: To observe the effect of propofol on jugular venous oxyhemoglobin saturation (SjO 2) duing rewarming period of cardiopulmonary bypass (CPB). Methods:22 patients undergoing heart valve replacement were allocated randomly into two groups. The patients in group Ⅰ propofol 4～6mg·kg -1 ·h -1 was infused continuously from the beginning of rewarming to 15 min after the end of CBP, while propofol was not used in group Ⅱ. The change of SjO 2 in two groups was observed at the follwing time points:before CBP, at 5 min after CBP, stable hypothermia stage, nasopharyngeal temperature (NPT) rewarmed to 34℃,5 min and 10 min after the end of CPB. Results: SjO 2 in group Ⅰ was higher significantly than that in group Ⅱ at NPT 34℃ and 5 min after the end of CPB (P<0 01,P<0 05). Cerebral oxygen extraction rate in group Ⅰ was lower significantly than that in group Ⅱ (P<0 01,P<0 05), although it was not lower significantly at NPT34℃ and 5 min after the end of CPB in group Ⅰ than that before CPB and after CPB. Conclusion:Propofol can prevent SjO 2 decrease during the rewarming period of CPB, thus it might have cerebral protection effect to some extent.

关 键 词：异丙酚 心肺转流 体外循环 脑氧供失衡 

分 类 号：R654.1[医药卫生—外科学] R971.2[医药卫生—临床医学]