【摘要】 目的　观察体外循环 (CPB)冠脉搭桥 (CABG)手术期脑氧供需平衡变化 ,并与双瓣置换 (DVR)手术患者进行比较。方法　 CABG和 DVR患者各 30例 ,取右颈内静脉球部和桡动脉血进行血气分析及乳酸测定 ,并计算动脉 -颈内静脉血氧含量差 (Ca- j O2 )、脑乳酸产量 (ADVL)、脑氧摄取率 (OER)和乳酸 -氧指数 (L OI)。结果　 1CPB开始前上述指标变化不明显 ,CPB低温期间颈内静脉氧饱和度 (Sj O2 )和氧分压 (Pj O2 )明显升高 ,复温期间下降 ,但与麻醉前比无差异 ,各观察时间点两组间差异无显著性。 2手术开始后 ,动脉和静脉血乳酸均渐增加 ,ADVL变化不明显 ,但在低温和复温时 ,CDBG组的 ADVL和 L OI高于 DVR组。结论　两组患者 CPB期间可基本维持全脑氧供需平衡 ,而 CABG组 ADVL和 L OI高于 DVR组 ,是否存在局灶性脑氧供需失衡有待进一步研究更多还原

【Abstract】 Objective To observe the perioperative changes of cerebral oxygen balance in patients undergoing coronary artery bypass grafting(CABG)compared with double vales replacement(DVR).Methods Blood gas analysis and lactate concentration in arterial and jugular bulb blood were monitored during operation,from which the arteriojugular venous oxygen content difference(Ca jO 2),cerebral lactate production(ADVL) cerebral oxygen extraction ratio(OER),and lactatr oxygen index(LOI)were calculated in patients with CABG and DVR(30 patients in each group).Results ①Parameters mentioned above had no significant changes before initiation of CPB.Jugular venous oxygen saturation(SjO 2)and oxygen partial pressure(PjO 2) significantly increased during hypothermia and significantly decreased during rewarming,but no statistical differences compared with the levels before anesthesia.②Arterial and jugular venous blood lactate increased gradually after the surgery began,but ADVL did not change significantly.ADVL and LOI were higher in CABG group than those in DVR group .Conclusion Total cerebral oxygen balance are maintained in two groups during CPB.Whether the local cerebral oxygen unbalance exists in CABG group needs further study.更多还原