An evaluation of brain blood flow with the single cerebral perfusion method during aortic arch aneurysm graft replacement

主动脉弓动脉瘤置换术中单一脑灌注法评价脑血流

• 批准号: 05671134
• 负责人: TAKABA Toshihiro
• 金额: $ 0.64万
• 依托单位: Showa University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for General Scientific Research (C)
• 财政年份: 1993
• 资助国家: 日本
• 起止时间: 1993 至 1994
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-05671134/
• 关键词: Selective cerebral perfusion; Blood flow velocity in the opthalmic artery; Doppler ultrasonography; ドプラエコー

1. ControlDuring 10 open heart surgeries in adults, blood flow velocity in the ophthalmic crtery (OAV) and common carotid artery (CAV) were measured with Doppler ultrasonography, and blood flow volume in the brachiocephalic artery (BA flow) was measured simultaneously with an electromagnetic flow meter. When CPB pump flow was varied, OAVmax more accurately reflected changes in pump flow than did CAVmax and BA flow. Because vessel resistance in the OA was small during CPB,OAVmax was thought to be determined by pump flow of CPB.OAVmax was useful for monitoring brain blood flow during CPB.2. Single cerbral perfusion (SCP) in cases of aortic arch aneurysmDuring two surgical repairs of aortic arch aneurysms, OAVmax before CPB was 0.19m/sec on right side and 0.23m/sec on left side, and that before SCP was 0.09m/sec and 0.10m/sec respectively. During SCP,OAVmax was 0.07m/sec at the perfusion site (right) and 0.06m/sec at the nonperfusion site (left) at perfusion flow rates of 600 to 700ml/min. Changes in OAVmax at the start of CPB,before SCP,during SCP,after SCP,and after CPB were 73.7%, 47.4%, 36.8%, 121.1%, and 231.6% at the perfusion site and 82.6%, 43.5%, 26.1%, 152.2%, and 217.4% at the nonperfusion site. Oxidation levels of cytochrome and hemoglobin were nearly constant during measurements of brain tissue oxygenation. Oxygen saturation in the jugular vein was normal. Levels of lactic acid and pyruvic acid increased, but there were no differences between the right and left sides. Measurement of OAV at both the perfusion and nonperfusion sites is useful for monitoring brain blood flow during SCP.The safety of SCP was also confirmed.

1.对照组在10例成人心脏直视手术中，用多普勒超声测量了眼动脉（OAV）和颈总动脉（CAV）的血流速度，同时用电磁流量计测量了头臂动脉的血流量（BA流量）。当CPB泵流量变化时，OAVmax比CAVmax和BA流量更准确地反映泵流量的变化。结论：1.由于体外循环中OA的血管阻力较小，OAVmax可由体外循环的泵流量决定，可用于体外循环中脑血流量的监测.主动脉弓瘤的单次脑灌注（SCP）在两次主动脉弓瘤手术中，CPB前OAVmax右侧为0.19m/sec，左侧为0.23m/sec，SCP前分别为0.09m/sec和0.10m/sec。在600 ~ 700 ml/min的灌注流量下，OAVmax在灌注部位（右）为0.07m/sec，在非灌注部位（左）为0.06m/sec，在转流开始时、转流前、转流中、转流后的变化分别为73.7%、47.4%、36.8%、121.1%。灌注部位为231.6%，非灌注部位为82.6%、43.5%、26.1%、152.2%和217.4%。在脑组织氧合测量过程中，细胞色素和血红蛋白的氧化水平几乎恒定。颈静脉血氧饱和度正常。乳酸和乳酸水平升高，但左右侧之间无差异。结果表明，脑血流灌注和非灌注部位OAV的测定有助于监测SCP过程中脑血流的变化，并证实了SCP的安全性。

项目成果

饗場正宏: "眼動脈血流エコーによる体外循環中の脳内血流動態" 日本心臓血管外科学会雑誌. 24. 153 (1995)

Masahiro Yoba：“使用眼动脉血流回波进行体外循环时的脑内血流动力学”日本心血管外科学会杂志 24. 153 (1995)。