【摘要】 目的探讨过度换气对神经外科手术中颅内压(ICP)、脑血流(CBF)及脑代谢(BM)的影响。方法选择期颅内肿瘤(颅内压在正常范围内)患者20例,快速诱导气管内插管全麻后,过度换气至PETCO230、25、20 mmHg等不同阶段,分别记录基础值、插管时及上述时段监测指标。结果过度换气后颅内压呈明显下降趋势,与基础值和插管时相比均有明显差异;血乳酸浓度(RS)与麻醉前相比无升高趋势,无统计学差异;脑血流与麻醉前及插管时相比均下降,差异极为显著(P<0.01)。结论适当范围的过度换气(PETCO2下降至20 mmHg)不但对手术有利,而且不会造成脑乏氧,可以确保患者安全。更多还原

【Abstract】 Objective To investigate the effect of hyperventilation on the intracranial pressure,cerebral blood flow and cerebral metabolism.Methods Twenty patients with normal cerebral pressure who were performed operation were hyperventilated so that PETCO2 were maintained at 30,25,20 mmHg,then recorded CVP,CBF,ICP and BM.Results After hyperventilation ICP decreased significantly compared with baseline and intubation;the blood lactic acid did not increase compared with preanesthesia,without any statistical difference;CBF decreased significantly compared with preanesthesia and intubation,with a statistical difference(P<0.01).Conclusion The suitable hyperventilation(PETCO2>20 mmHg)is not only beneficial for the operation,but also without any cerebral hypoxia and safe for the patients.更多还原