脂化前列腺素E_1对体外循环稳定期脑灌注压和颈静脉血氧饱和度的影响  

Effects of Lipo-Prostaglandin E_1 on Systemic Hemodynamics and Jugular Venous Oxygen Saturation during Cardiopulmonary Bypass

作　　者：赵一凡[1] 陈倩茹[2] 胡楚文[1] 李珏[1] 

机构地区：[1]中山大学孙逸仙纪念医院麻醉科,510120 [2]中山大学中山眼科中心麻醉科

出　　处：《岭南急诊医学杂志》2013年第5期329-332,共4页Lingnan Journal of Emergency Medicine

基　　金：广东省科技计划项目(201113080701077);广东省医学科研基金(B2010084)

摘　　要：目的:探讨在体外循环稳定期使用脂化前列腺素E1对脑灌注压和颈静脉血氧饱和度的影响。方法:30例预计在体外循环下行冠状动脉旁路手术的患者随机分为3组:PGE125组(n=10):输注脂化前列腺素E125 ng/(kg·min);PGE1 50组(n=10):输注脂化前列腺素E150 ng/(kg·min);对照组(CON组,n=10):输注等量生理盐水。观察并记录基础状态下MAP、颈静脉血氧饱和度(SjvO_2),颈静脉球血压(IJP),脑灌注压值(CPP),血色素(Hb),鼻温;在体外循环开始20 min,血压平稳时,开始按分组情况给药,记录给药后2,5,10,20,30 min以及停止输注后30 min以上参数。结果:与CON组比较,PGE150组T20和T30的MAP,CPP均显著降低(P<0.05),且PGE1 50组与PGE1 25组比较亦显著降低(P<0.05)。T20,T30两时点上PGE1 25和PGE1 50组的MAP,CPP均较基础值T0明显降低(P<0.05)。IJP和SjvO_2在各组,各时点上均无显著差异。结论:在体外循环过程中使用脂化前列腺素E1可使体循环血压和脑灌注压下降,但对脑氧供需平衡不产生明显影响。Objective：To explore the effects of Lipo-Prostaglandin E1 on systemic hemodynamics and cerebral oxygenation during cardiopulmonary bypass （CPB）. Methods： 30 patients who underwent elective coronary artery bypass graft surgery were randomly assigned into three groups： PGE1 25 group （n=10） received an infusion of Lipo- Prostaglandin E1 25 ng/（kg·min）, PGE1 50 group （n=10） received an infusion of Lipo-Prostaglandin E1 50 ng/（kg· min）, and the control group （n=10） received an infusion of saline. The baseline MAP, jugular venous oxygen saturation （SjvO2）,internal jugular venous pressure （IJP）, cerebral perfusion pressure （CPP）, hemoglobin （Hb）, and nasal temperature were measured. 20 minutes after the CPB, the drug was infused intravenously at its rate. The blood gas analysis and cardiovascular hemodynamie parameters were simultaneously determined at 2, 5, 10, 20, and 30 min during drug infusion, and at 30 min after discontinuation of the drug infusion. Results：Compared with control group, the MAP and CPP of PGE1 50 group was decreased at T20 and T30 （P〈0.05）, and it was more obviously in PGEx 50 group than PGEI 25 group（P〈0.05）. MAP and CPP in PGE1 25 and PGE1 50 groups was decreased 20 and 30 min after the start of Lipo-Prostaglandin E1 infusion compared with the baseline value （P〈0.05）. There was no change in SjvO2 and IJP value despite a decrease in MAP and CPP during the study. Conelsions： To infuse Lipo- Prostaglandin E1 during CPB could make a decrease in hemodynamic, but the cerebral oxygenation estimated by SjvO2 is maintained.

关 键 词：前列腺素E1 体外循环 血流动力学 颈静脉血氧饱和度 

分 类 号：R654.1[医药卫生—外科学]