摘要
目的 观察异氟醚控制性降压对颅内动脉瘤夹闭术病人组织氧供、氧耗及氧合状态变化的影响。方法 2 1例择期手术病人在全麻下于剥离夹闭动脉瘤时 ,加大异氟醚吸入浓度 ,使 MAP下降 (30～ 40 ) % ,维持 30～ 45分。夹闭动脉瘤后 ,减少异氟醚浓度 ,MAP回升至降压前水平。采用Swan- Ganz漂浮导管监测降压前、中、后血液动力学指标和氧动力学指标。监测相应血气和动脉乳酸浓度动态变化。结果 降压期间 CO、CI、SV、SI、RVSWI及 HR无明显变化 ,SVR、PVR、L VSWI、Cpp、RPP可逆性减少 (P<0 .0 5 )。 DO2 显著下降 ,ERO2 明显增加 ,VO2 无明显变化。降压时 S v O2 可逆性减少 (P<0 .0 5 )。乳酸浓度无明显变化。结论 异氟醚控制性降压期间能维持良好的组织氧供需平衡。
Objective To study effect of isoflurane induced hypotension on hemodynamics and oxygen delivery (DO 2),oxygen consumption (VO 2),VO/DO 2 ratio (ERO 2) and oxygenation during cerebral aneurysm operation.Methods Twenty one cerebral anuerysm patients were operated on under general anesthesia Inhalation concentration of isoflurane was elevated to reduce MAP by 30% 40% during dissection and occlusion of the aneurysm ,and was maintained for 30 45min. Hemodynamic values were measurd with Swan Ganz technique. Hemodynamics,oxygen kinetics and the blood level of lactate were tested during isoflurane deliberated hypotension. Results No significiant changes of CO,CI,SV,SI,RVSWI,HR and ECG tracing were observed during hypotension (P<0 05) SVR,PVR,Cpp,RPP and LVSWI were significantly decreased during hypotension,(P<0 05) During controlled hypotension DO 2 and S v O 2 decreased significiantly, ERO 2 increased significiantly and VO 2 and plasma lactate concentraion remained unchanged.Conclusion Isoflurane induced hyppension can keep a good balance between DO 2 and VO2, during cerdbral aneurysm operation
出处
《中华麻醉学杂志》
CSCD
北大核心
1999年第3期149-151,共3页
Chinese Journal of Anesthesiology
关键词
异氟烷
降压
氧耗
脑动脉瘤
外科手术
Isoflurane
Hypotension
controlled
Oxygen consumption
Brain
Aneurysm
