【摘要】 体外循环（ＣＰＢ）期间保证组织灌注对维持机体代谢有重要意义，而微循环自主运动对组织灌注有明显的影响。本研究观察１６例心脏瓣膜病人在ＣＰＢ中降温、复温时氧代谢和微循环自律运动的变化。结果表明，ＣＰＢ中微循环运动明显抑制。在同一温度条件下，复温时的微循环灌注流量（ＳＢＦ）比降温时明显增高，氧耗量（ＶＯ２）、氧摄取率（Ｏｚｅｘｔ）也表现出同样趋势。文章认为低温时氧利用率的降低在很大程度上和微循环功能抑制，动静脉短路有关。虽然降温时静脉氧饱和度很高，但一些组织（除大脑外）缺氧、缺血。文章提出在复温时要相应提高流量，以偿还降温时形成的氧债，保证ＣＰＢ中的有效灌注，提倡根据静脉氧饱和度进行流量调节。更多还原

【Abstract】 subcutaneous blood now (SBF ), microvascular vasomotion (MV ), Oxygen consumption (VO2)and oxygen extraction (O2ext) of 16 patients with valvular disease were observed after hypothermia and remarming during cardiopulmonary bypass (CPB ). The results revealed that SBF and MV during rewarming were much higher than that during cooling(p<0. 05 &. P<0. 01 ), VO2 and O2ext were in the same trendency. It is suggested that lower utilization of oxygen during hypothermia is related significantly with the depression of microcircular vasomotion, therefore it is important to increase the perfusion now in order to balance tissue oxygen demand during rewarming, and to monitor SvO2 constinuosly during CPB.更多还原