北京生物醫(yī)學(xué)工程

腦血紅蛋白濃度指數(shù)在體外循環(huán)中的應(yīng)用

JIA Zaishen, TENG Yichao, LI Yue, XIE Haixiu, LIU Yuan, HOU Xiaotong

作者：賈在申騰軼超李岳謝海秀劉媛侯曉彤

單位：                      首都醫(yī)科大學(xué)附屬北京安貞醫(yī)院，北京市心肺血管疾病研究所，心臟外科危重癥中心，體外循環(huán)及機(jī)械循環(huán)輔助科(北京100029)        

關(guān)鍵詞：腦；血紅蛋白濃度指數(shù)；近紅外光譜；體外循環(huán)；改良超濾

分類(lèi)號(hào)：

出版年·卷·期（頁(yè)碼）：2014·33·3（300-305）

摘要：

目的基于穩(wěn)態(tài)的近紅外光譜技術(shù)，可無(wú)創(chuàng)、實(shí)時(shí)監(jiān)測(cè)腦組織血紅蛋白濃度指數(shù)，以反映人體腦組織中
血紅蛋白總濃度變化的百分比，從而有利于評(píng)價(jià)腦血流動(dòng)力學(xué)及腦氧合。方法基于穩(wěn)態(tài)近紅外光在人體腦
組織中的傳播規(guī)律研發(fā)了近紅外組織血氧檢測(cè)儀，并用其無(wú)創(chuàng)、實(shí)時(shí)監(jiān)測(cè)了8例經(jīng)受體外循環(huán)手術(shù)的先天性
心臟病嬰兒的腦組織血紅蛋白濃度指數(shù)及腦組織氧飽和度。結(jié)果在體外循環(huán)末期的改良超濾階段，所有嬰
兒的腦組織血紅蛋白濃度指數(shù)均顯著上升，上升速率為(0.0304±0.0136) mM/(cm·min)，P<0.001。改良超
濾結(jié)束與起始時(shí)相比，腦血紅蛋白濃度指數(shù)增加了(18.8±7.5)%，這是由于改良超濾提高了血液的紅細(xì)胞容
積比。此過(guò)程中腦組織氧飽和度平均增加了(5.3±4.1)個(gè)百分點(diǎn)(P<0.05)，但不如腦血紅蛋白濃度指數(shù)的上
升趨勢(shì)明顯。結(jié)論在體外循環(huán)手術(shù)的改良超濾過(guò)程中，腦組織血紅蛋白濃度指數(shù)可有效反映腦組織血流動(dòng)
力學(xué)與氧合的變化。

Objective Using continuous-wave near infrared spectroscopy (NIRS), human cerebral
tissue hemoglobin concentration index (tHI) is detected non-invasively and in real time, so
that the change percentage of cerebral total hemoglobin concentration can be indicated and
cerebral hemodynamics as well as oxygenation can be evaluated. Methods Based on the
propagation of near-infrared light in human brain, the near-infrared oximeter was developed,
and the cerebral tHI as well as cerebral oxygen saturation of 8 infants suffered from
congenital heart disease were monitored non-invasively and in real time under cardiopulmonary
bypass. Results During modified ultrapurification in the end of cardiopulmonary bypass, the
cerebral tHI of all the infants increased significantly at the average speed of (0.0304±
0.0136) mM/(cm?min), P<0.001. Comparing the end to the beginning of modified
ultrapurification, the cerebral tHI increased for (18.8±7.5) %, because the hematocrit was
increased by filtering out the redundant water in the blood. The cerebral oxygen saturation
increased for (5.3±4.1) % (P<0.05), which was not so obvious as the increase trend of
cerebral tHI. Conclusions During modified ultrapurification in the end of cardiopulmonary
bypass, the changes of cerebral hemodynamics and oxygenation may be indicated effectively by
cerebral tHI.

參考文獻(xiàn)：

服務(wù)與反饋：

【文章下載】【加入收藏】

提示：您還未登錄，請(qǐng)登錄！點(diǎn)此登錄

51黑料吃瓜在线观看,51黑料官网|51黑料捷克街头搭讪_51黑料入口最新视频