超声造影技术对成人体外循环中肾脏微循环灌注状态的初步研究

发布时间：2018-06-27 09:22

  本文选题：超声造影 + 体外循环　； 参考：《四川大学学报(医学版)》2015年06期

【摘要】：目的探讨体外循环转流对成人肾脏微循环灌注的影响。方法纳入择期行体外循环心脏手术成人患者6例和非心脏手术的成人患者12例,分别于体外循环建立30min和麻醉诱导结束生命体征稳定5min后获取肾脏超声造影图像,采用超声造影技术分析比较成人非搏动性体外循环与麻醉诱导后的肾脏微循环灌注。分析比较两种条件下肾脏不同区域的灌注时间强度曲线(TIC)的相关参数:上升支斜率(α)、达峰时间(TTP)、峰值强度(PI)、曲线下面积(AUC)。结果与全身麻醉状态相比,体外循环下肾脏浅层皮质、深层皮质和髓质锥体区域TIC的AUC均降低(P0.05),体外循环组肾脏髓质区域AUC低于同条件下的浅层皮质以及深层皮质的AUC(P0.05)。所有患者均未出现超声微泡造影剂相关的不良事件。结论体外循环下肾脏各个区域的微循环灌注出现了明显下降,其中以髓质区域下降最为明显。超声造影技术可用于监测心脏手术期间肾脏微循环灌注状态。
[Abstract]:Objective to investigate the effect of cardiopulmonary bypass (CPB) on renal microcirculation perfusion in adults. Methods six adult patients undergoing cardiopulmonary bypass (CPB) and 12 adults undergoing non-cardiac surgery were enrolled in this study. Renal contrast-enhanced imaging was obtained after cardiopulmonary bypass (CPB) and anesthesia induction (30min) and stable vital sign (5min) after anesthesia induction. Contrast-enhanced ultrasonography was used to analyze and compare the renal microcirculation perfusion between adult non-pulsatile cardiopulmonary bypass and anesthetic induction. The parameters of perfusion time intensity curve (TIC) in different areas of kidney under two conditions were analyzed and compared: slope of ascending branch (伪), peak time (TTP), peak intensity (Pi), area under curve (AUC). Results compared with general anesthesia, the AUC of TIC in the superficial cortex, deep cortex and medullary pyramidal area of the CPB group was lower than that in the superficial cortex and deep cortex under cardiopulmonary bypass (P0.05), and the AUC in the medullary area of the kidney in the CPB group was lower than that in the superficial cortex and deep cortex under the same condition (P0.05). No adverse events related to ultrasound microbubbles were found in all patients. Conclusion under cardiopulmonary bypass (CPB), the microcirculation perfusion in various areas of the kidney decreased significantly, especially in the medullary area. Contrast-enhanced ultrasonography can be used to monitor renal microcirculation during cardiac surgery.
【作者单位】： 四川大学华西医院麻醉科;四川大学华西医院超声科;四川大学华西医院心外科;
【基金】：四川省科技厅科技支撑计划项目(No.2012FZ0121)资助
【分类号】：R614

【参考文献】

相关期刊论文 前2条

1 钟晓绯;朱达;卢强;刘斌;彭玉兰;;超声造影监测儿童及婴幼儿体外循环下肾脏微循环灌注的初探[J];四川大学学报(医学版);2013年04期

2 邱逦;冷钱英;罗燕;;超声联合微泡造影在分子影像诊断及治疗中的研究进展[J];四川大学学报(医学版);2014年06期

【共引文献】

相关期刊论文 前2条

1 刘慧;付勇;陈晓梅;邓明彬;于风旭;李明星;;肾血流阻力指数在儿童和成人体外循环术后改变特点研究[J];中国临床医学影像杂志;2014年06期

2 Jun Liu;Zhifeng Kou;Yongquan Tian;;Diffuse axonal injury after traumatic cerebral microbleeds: an evaluation of imaging techniques[J];Neural Regeneration Research;2014年12期

【二级参考文献】

相关期刊论文 前2条

1 唐远姣;张凌燕;王磊;林玲;文晓蓉;邱逦;;治疗性超声介导微泡破裂促进大鼠体内肌肉基因转染的参数优化实验研究[J];四川大学学报(医学版);2012年06期

2 魏立亚;何文;张红霞;刘冬梅;王立淑;邬冬芳;田凤兰;;颈动脉硬化斑块内新生血管的超声造影研究[J];中华医学超声杂志(电子版);2009年06期

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