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颅脑手术病人术中亚低温的脑保护作用 |
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王涛 赵继宗 赵元立
摘 要：目的 观察颅脑手术病人术中亚低温(33°C～35°C)对脑代谢的影响，探讨其脑保护作用。方法 颅脑手术病人20例，随机分为亚低温组(n=10)和常温对照组(n=10)，术中脑温分别维持在33°C～35°C和36°C～37°C。颈内静脉逆行置管同步采集颈内静脉血和动脉血行血气分析、葡萄糖含量测定，计算脑动-静脉血氧含量差(Da-vO2)、脑氧摄取率(ERO2)、脑动-静脉血糖差(Da-vglu)、脑葡萄糖摄取率(ERglu)。结果 亚低温组降温后Da-vO2、ERO2、Da-vglu、ERglu较降温前及常温对照组明显下降(P＜0.01)。结论 亚低温能显著降低颅脑手术病人脑氧、葡萄糖代谢，增加脑组织对损伤的耐受性，起到术中脑保护的作用。
关键词：亚低温 颅脑手术 脑保护
Mild Hypothermic cerebral protection during craniotomy
Wang Tao
(Department of Neurosurgery, Beijing Tiantan Hospital, China Academy
of Medical Sciences, Beijing 100050)
Zhao Jizong
(Department of Neurosurgery, Beijing Tiantan Hospital, China Academy
of Medical Sciences, Beijing 100050)
Zhao Yuanli
(Department of Neurosurgery, Beijing Tiantan Hospital, China Academy
of Medical Sciences, Beijing 100050)
Abstract：Objective To observe the influence of mild hypothermia (HT) during craniotomy on cerebral metabolism and to investigate its cerebral protective action. Method Twenty patients scheduled for craniotomy were randomly divided into two groups: mild hypothermic (HT) group (n=10) and normothermic (NT) group (n=10). Brain temperature (BT) of each group was maintained at 33°C～35°C and 36°C～37°C respectively. Arterial and venous blood samples were drainaged simultaneously through artery and internal jugular catheterization, then blood gas analysis and glucose measurement were undergone. The cerebral arteriovenous differences of oxygen and glucose content (Da-vO2 and Da-vglu) and extracting rats of oxygen and glucose (ERO2 and ERglu) wete calculated. Result Da-vO2, Da-vglu, ERO and ERglu of mild HT group when BT decreased were significantly less than that of NT group. Conclusion Mild HT can confer remarkable cerebral protection through significantly decreasing cerebral metabolism of oxygen and glucose during craniotomy.
Key words：Mild Hypothermia Craniotomy C[1] [2] [3] 下一页
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