Research for natural prognosis and surgical effect in thoracic and abdominal aneurysm

胸腹动脉瘤自然预后及手术效果研究

• 批准号: 04557059
• 负责人: MATSUDA Hikaru
• 金额: $ 11.14万
• 依托单位: Osaka University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Developmental Scientific Research (B)
• 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/grant/KAKENHI-PROJECT-04557059/
• 关键词: cardiopulmonary bypass; moderate hypothermia; separate brain perfusion; oxy hemoglobin; deoxy hemoglobin; nearinfrared spectroscopy; 体外循環; 脳障害; 脳組織pH; 脳内酸素量; 脳実質pH; 内頚静脈血酸素飽和度; 低体温

*In 1992 and 1993* We have established the cardiopulmoanry bypass (CPB) model of the rabbit, and we studied the relationship the brain pH,the saturation of internal jugular vein (SjO2) and the hemoglobin (Hb) in the arterial blood. And next, we have sudied the relationship the brain damage induced by the decreasing the brain blood flow, the brain pH and the oxyhemoglobin in the next experiment. Results were as followed ;1)The brain pH was elavated during the hypothermic CPB and the brain pH,the Hb value and the SjO2 indicated the positive correlation (r=0.634, r=0.620) .2)The more the blood dilition proceeded, the more the acidosis of brain pH.3)The deoxyHb in the brain was increaed according to the decreasing of the brain blood flow, and showed the value of 15.8 <plus-minus> 11.9muM when the brain blood flow was 30ml/kg/mi4)The brain pH showed the negative correlation with the deoxyHb.*In 1994* We measured and considered the oxy and deoxyHb in the open heart surgery using the hypothemic CPB and in the patients using the separate brain perfusion. Results were as followed ;1)The oxyHb showed the lower value than the control during the hypothermic CPB in adult patients (p<0.05) and the deoxyHb higher(p<0.05).2)The oxyHb showed significantly higher than the control during the hypothemic CPB in pediatric patients.3)The brain perfusion flow and the oxyHb showed the positve relationship.4)It was suggested that the measurement of the oxyHb and the deoxyHb would become the reliable monitor of the cerebral perfusion during the CPB

我们于1992年和1993年建立了家兔体外循环（CPB）模型，研究了脑pH、颈内静脉血氧饱和度（SjO_2）与动脉血血红蛋白（Hb）的关系。在接下来的实验中，我们研究了脑血流量减少引起的脑损伤与脑pH值和氧合血红蛋白的关系。结果如下：1）低温体外循环时脑pH升高，脑pH、Hb值与SjO_2呈正相关（r=0.634，r=0.620）; 2）随着血液循环的进行，脑pH酸中毒程度加重; 3）脑内脱氧Hb随脑血流量的减少而升高，<plus-minus>当脑血流量为30 ml/kg/ml时，脑内脱氧Hb为15.8 ~ 11.9 μ M;我们于1994年对低温体外循环心脏直视手术和脑灌注病人的氧合血红蛋白和脱氧血红蛋白进行了测定和研究。结果如下：1）成人患者低温体外循环期间氧合血红蛋白低于对照组（p&lt;0.05）和脱氧血红蛋白较高2）小儿低温CPB时氧合血红蛋白明显高于对照组（P&lt;0.05）; 3）脑灌注流量与氧合血红蛋白呈正相关（P&lt;0.05）。提示氧合血红蛋白和脱氧血红蛋白的测定可成为CPB期间脑灌注的可靠监测指标