Near-infrared monitoring of cerebral oxygenation state during carotid endarterectomy.
Near-infrared monitoring of cerebral oxygenation state during carotid endarterectomy.
复制标题
颈动脉内膜切除术中脑氧合状态的近红外监测。
DOI：
10.1016/0090-3019(95)00463-7
复制
发表时间：
1996
影响因子：
--
通讯作者：
M. Tamura
中科院分区：
文献类型：
--
作者：
S. Kuroda;K. Houkin;H. Abe;Y. Hoshi;M. Tamura
背景近年来的研究表明，近红外光谱（NIRS）利用其光学特性，可以连续、无创地观察缺氧和缺血时脑氧合状态的变化。然而，其在脑血管手术中的有效性和实用性仍有待阐明。方法使用NIRS连续监测22名患者颈动脉内膜切除术期间氧合血红蛋白、脱氧血红蛋白和总血红蛋白（分别为[oxy-HB]、[deoxy-Hb]和[total Hb]）浓度的变化以及细胞色素氧化酶（cyt ox）的氧化还原状态。我们将 NIRS 反应与术中体感诱发电位 (SEP) 和局部脑血流量 (rCBF) 进行了比较。 结果 在 22 名患者中，有 9 名患者因颈动脉交叉夹闭导致 [氧血红蛋白] 和 [总血红蛋白] 持续下降，而 [脱氧血红蛋白] 增加。细胞色素氧化在夹紧过程中部分减少。这些 NIRS 反应表明同侧脑组织发生严重缺氧。这些患者的 SEP 和 rCBF 的 N20 振幅显着降低。相比之下，另外13例患者的脑氧合状态并未出现明显下降，无论是SEP还是rCBF均未出现明显变化。结论NIRS能够在颈动脉手术过程中成功无创地判断脑氧合状态，并且比其他间接方法对缺血危象更敏感。
BackgroundRecent studies have indicated that near-infrared spectroscopy (NIRS) could continuously and noninvasively observe the changes in cerebral oxygenation state during hypoxia and ischemia, using their optical properties. Its validity and usefulness during cerebrovascular surgery, however, still remain to be clarified.MethodsUsing NIRS, we continuously monitored the changes in the concentration of oxyhemoglobin, deoxyhemoglobin, and total hemoglobin ([oxy-HB],[deoxy-Hb], and [total Hb], respectively) and redox state of cytochrome oxidase (cyt ox) during carotid endarterectomy for 22 patients, and we compared the NIRS responses with those of intraoperative somatosensory evoked potentials (SEP) and regional cerebral blood flow (rCBF).ResultsIn 9 of 22 patients, cross-clamping of the carotid artery caused a continuous decrease [oxy-Hb] and [total Hb], and an increase in [deoxy-Hb]. Cyt ox was partially reduced during the clamping. These NIRS responses demonstrated the occurrence of severe hypoxia in the ipsilateral cerebral tissue. These patients showed a marked decrease in the N20 amplitude of SEP and rCBF. In contrast, the other 13 patients did not show a significant decrease in the cerebral oxygenation state, which showed no remarkable changes in either SEP or in rCBF.ConclusionsNIRS could successfully jude the cerebral oxygenation state noninvasively during carotid surgery and was more sensitive to ischemic crisis than other indirect methods.
DOI：
10.1073/pnas.85.14.4971
发表时间：
1988-07-01
影响因子：
11.1
作者：
CHANCE, B;LEIGH, JS;BORETSKY, R
通讯作者：
BORETSKY, R
不完全短暂性缺血：大鼠脑体内脑代谢和血流动力学的无损评估。
影响因子：
8.3
作者：
Wiernsperger,N;Sylvia,AL;Jöbsis,FF
通讯作者：
Jöbsis,FF