控制性降压期间脑组织血流及氧供需平衡状况的临床研究  

The Effects of Sodium Nitroprusside induced Hypotension at Different Levels on Cerebral Blood Flow and Metabolism:a Clinical Study

作　　者：徐仲煌[1] 任洪智[1] 黄宇光[1] 张秀华[1] 罗爱伦[1] 叶铁虎[1] 

机构地区：[1]中国医学科学院中国协和医科大学协和医院麻醉科,北京100730

出　　处：《中国医学科学院学报》2000年第4期360-363,共4页Acta Academiae Medicinae Sinicae

摘　　要：目的　观察不同水平控制性降压时脑血流量及氧供需平衡状况。方法　将 30例临床择期手术患者随机分成 3组 ,每组均为 10例。组 1(G1)控制性降压”水平为平均动脉压 (MAP) 5 5 mm Hg,组 2 (G2 )为 6 5 m m Hg,组3(G3)未施降压 ,作为对照。采用频率为 2 MHz的经颅多普勒脑血流速度仪 (TCD)测定大脑中动脉血流速率 ,同时监测颈内静脉血氧饱和度、动静脉乳酸浓度及其他血生化指标。结果　 G1、G2组平均动脉压分别降至 5 5、6 5mm Hg,维持 1h,上述两组脑组织血供及代谢指标与对照组间差异无显著意义。结论　吸入性全麻下用 0 .0 1%硝普钠 (SNP) +安氟醚 (ENF) ,血压降至 5 5 mm Hg,维持 1h,在供氧充分的情况下 ,对脑血流量及氧供需平衡无明显影响 ,因而该方法是安全可靠的。Objective The clinical experiment was designed for observing the effects of deliberate hypotension at different level on cerebral blood flow and metabolism Methods 30 ASA Grade Ⅰ～Ⅱ patients were randomly allocated to one of three groups(each group n=10) Hypotension was induced by sodium nitroprusside in group 1[mean arterial pressure (MAP)=55 mmHg]and group 2(MAP=65 mmHg) Group 3(control)was on normotension The changes of cerebral blood flow during hypotension were estimated according to the variability of cerebral blood flow velocity (CBFV)in the middle cerebral artery(MCA),which was obtained through transcranial Doppler ultrasonography (TCD) Results Hypotesion caused a moderate decrease in CBFV,but no significant difference,in CBFV and oxygen saturation in internal jugular vein(SjO 2),either among three groups or during the procedure Conclusions It is safe for cerebral perfusion and metabolism with deliberate hypotension at MAP=55 mmHg

关 键 词：控制性降压 脑血流 经颅多普勒超声 氧供需平衡 

分 类 号：R614.26[医药卫生—麻醉学]