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[低血压麻醉对心脏、肾脏和肝脏组织氧张力的影响]

[Effect of hypotensive anesthesia on tissue oxygen tension of the heart, kidney and liver].

作者信息

Hashimoto K, Okazaki K, Okutsu Y, Tateyama T, Okumura F

机构信息

Department of Anesthesia, Yokohama City University Urahune Hospital.

出版信息

Masui. 1992 Aug;41(8):1267-70.

PMID:1433848
Abstract

The effects of hypotensive anesthesia by prostaglandin E1 (PGE1: 8 dogs) or trimetaphan (TMP: 8 dogs) on tissue oxygenation were studied in 16 mongrel dogs anesthetized with pentobarbital. Mean blood pressure (MBP), heart rate (HR), cardiac output (CO), blood gases (BG), the blood flow and tissue oxygen tension of the heart, the kidney and the liver were measured. The blood flow and oxygen tension were measured by electromagnetic flowmeters and by polarographic oxygen electrodes respectively. PGE1 or TMP was injected intravenously to decrease MBP by 30%. MBP, CO, HR and BG of PGE1 were not significantly different with those of TMP. Coronary blood flow decreased for 12% with PGE1 and for 33% with TMP. Though blood flows of the renal and the hepatic arteries were well maintained with PGE1, they decreased for 36% and 34% respectively with TMP. Oxygen tensions of the myocardium (both outer and inner layers) and the liver were well maintained with PGE1. But with TMP, oxygen tension decreased for 23% in outer layer, for 16% in inner layer and for 31% in the liver. Oxygen tension of the kidney remained unchanged with PGE1 and TMP. The results suggest that PGE1 is more useful for the maintenance of the tissue oxygenation than TMP during hypotensive anesthesia.

摘要

在16只戊巴比妥麻醉的杂种犬中,研究了前列腺素E1(PGE1:8只犬)或阿方那特(TMP:8只犬)低血压麻醉对组织氧合的影响。测量了平均血压(MBP)、心率(HR)、心输出量(CO)、血气(BG)、心脏、肾脏和肝脏的血流量及组织氧张力。血流量和氧张力分别通过电磁流量计和极谱氧电极进行测量。静脉注射PGE1或TMP使MBP降低30%。PGE1组的MBP、CO、HR和BG与TMP组无显著差异。PGE1使冠状动脉血流量减少12%,TMP使冠状动脉血流量减少33%。虽然PGE1能很好地维持肾动脉和肝动脉的血流量,但TMP使肾动脉和肝动脉血流量分别减少36%和34%。PGE1能很好地维持心肌(外层和内层)和肝脏的氧张力。但TMP使外层氧张力降低23%,内层降低16%,肝脏降低31%。PGE1和TMP对肾脏氧张力无影响。结果表明,在低血压麻醉期间,PGE1比TMP更有助于维持组织氧合。

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