先天性心脏病患儿术前脑组织氧合的观察

发布时间：2018-05-19 21:24

本文选题：先天性心脏病 + 脑组织氧合指数　；参考：《上海交通大学学报(医学版)》2017年04期

【摘要】：目的·观察心内不同分流方向对先天性心脏病患儿术前局部脑组织氧合的影响。方法·选择年龄在4~24个月择期手术的室间隔缺损(VSD组)、法洛四联症(TOF组)及腹股沟斜疝(对照组)患儿,每组各20例。采用NIRS监测患儿前额两侧局部脑组织氧合指数(TOI)。测量并记录患儿血氧饱和度(SpO_2)、无创血压(NIBP)、心率(HR)。比较3组患儿TOI及局部脑组织氧摄取率(FTOE),分析患儿TOI的影响因素。结果·VSD组患儿术前两侧TOI与对照组患儿比较,差异无统计学意义(P0.05)。TOF组患儿两侧TOI均明显低于其余2组(均P=0.000),FTOE较VSD组患儿增高(P=0.005)。多元线性回归分析显示先天性心脏病患儿TOI只与SpO_2相关(r=0.560,P=0.000)。结论·不同的分流方向可通过影响先天性心脏病患儿的体循环氧供而影响脑组织氧合。右向左分流先天性心脏病患儿,SpO_2降低导致TOI降低,FTOE继发性升高。
[Abstract]:Objective to observe the effect of different shunt directions on regional cerebral oxygenation in children with congenital heart disease before operation. Methods VSD group, TOF group and indirect inguinal hernia group (20 cases in each group) were selected. NIRS was used to monitor the regional cerebral oxygenation index (TOI) in both frontal and bilateral regions of children. The blood oxygen saturation was measured and recorded. The TOI and the oxygen uptake rate of brain tissue were compared among the three groups, and the influencing factors of TOI were analyzed. Results compared with the control group, the bilateral TOI in the VSD group was significantly lower than that in the other two groups (P < 0.05). The TOI in both groups was significantly higher than that in the VSD group (P = 0.005). Multiple linear regression analysis showed that TOI was only associated with SpO_2 in children with congenital heart disease. Conclusion different shunt directions may affect cerebral oxygenation by affecting systemic oxygen supply in children with congenital heart disease. Right to left shunt in children with congenital heart disease resulted in the decrease of TOI and secondary increase of FTOE.
【作者单位】：上海交通大学医学院附属上海儿童医学中心麻醉科;
【基金】：上海市浦东新区科技发展基金创新资金项目(PKJ2013-Y61)~~
【分类号】：R726.5

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