Ohe Y, Satoh K, Hashimoto N, Tachibana C, Fukada T, Furuya Y
Department of Anesthesiology, Tokyo Women's Medical College Daini Hospital.
Masui. 1992 Oct;41(10):1598-602.
The forehead tissue temperature (FT-T) and the sole tissue temperature (ST-T) were measured and recorded by a deep body thermometer (Terumo Corp.) during open heart surgery. The changes in FT-T and ST-T after cardiopulmonary bypass (CPB) showed two characteristic patterns; the convergence pattern and the dissociation pattern. It is said that the dissociation pattern can notes a poor peripheral circulation. The deverging point of the two patterns was studied in 65 patients with acquired cardiac disease. We divided the patients into two groups taking 3.5 degrees C of the FT-T and ST-T difference (DT) after 2 hour weaning from CPB. The number of the patients in convergence group (group I) was 42, and that in the dissociation group (group II) was 23. The two groups were compared with the DT and the time required for the rise in each temperature from CPB rewarming to CPB weaning. There was no intergroup difference in the DT when the FT-T began to rise upon CPB rewarming. However, the DT was 3.8 +/- 2.3 (mean +/- SD) degrees C in group I and 7.1 +/- 1.8 degrees C in group II when the ST-T began to rise, and 4.2 +/- 2.5 degrees C in group I and 6.9 +/- 1.4 degrees C in group II when the FT-T reached its peak; the figures were significantly lower in group I (P < 0.01). The time required for the rise in ST-T was significantly shorter in group I (14.8 +/- 17.1 min) than in group II (25.8 +/- 14.7 min).(ABSTRACT TRUNCATED AT 250 WORDS)
在心脏直视手术期间,使用深部体温计(泰尔茂株式会社)测量并记录前额组织温度(FT-T)和足底组织温度(ST-T)。体外循环(CPB)后FT-T和ST-T的变化呈现出两种特征模式:趋同模式和解离模式。据说解离模式提示外周循环不良。对65例获得性心脏病患者的两种模式的分离点进行了研究。我们根据CPB停机2小时后FT-T和ST-T的差值(DT)为3.5℃将患者分为两组。趋同组(I组)有42例患者,解离组(II组)有23例患者。比较两组的DT以及每种温度从CPB复温到CPB停机上升所需的时间。CPB复温时FT-T开始上升时,两组的DT无组间差异。然而,ST-T开始上升时,I组的DT为3.8±2.3( mean±SD)℃,II组为7.1±1.8℃;FT-T达到峰值时,I组为4.2±2.5℃,II组为6.9±1.4℃;I组的数值显著更低(P<0.01)。I组ST-T上升所需时间(14.8±17.1分钟)明显短于II组(25.8±14.7分钟)。(摘要截断于250字)