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正颌外科手术自体献血过程中的自主神经系统活动。

Autonomic nervous system activity during autologous blood donation for orthognathic surgery.

作者信息

Seto Mika, Manabe Yozo, Taniguchi Shogo

机构信息

Department of Diagnostics and General Care, School of Dentistry, Fukuoka Dental College, Fukuoka, Japan.

出版信息

J Oral Maxillofac Surg. 2005 Aug;63(8):1096-100. doi: 10.1016/j.joms.2005.04.006.

Abstract

PURPOSE

The aim of this study was to assess by means of power spectral analysis the immediate response of autonomic regulation that occurs with postural change from supine to sitting position (modified head-up tilt test [m-HUT]) during autologous blood donation (ABD) and postphlebotomy infusion.

PATIENTS AND METHODS

We investigated 37 healthy adults who required preoperative ABD before elective orthognathic surgery. Measurements were conducted with m-HUT during ABD and postphlebotomy infusion. The data were analyzed using the maximum entropy method and the difference between supine and tilt was determined by analysis of variance.

RESULTS

When m-HUT was conducted at the resting state, cardiac parasympathetic nervous activity was significantly decreased, whereas cardiac and vascular sympathetic nervous activities were significantly increased. When m-HUT was conducted following blood collection, cardiac parasympathetic nervous activity showed a tendency to increase, whereas vascular sympathetic nervous activity was significantly increased. These changes were not observed during postphlebotomy infusion.

CONCLUSIONS

The m-HUT, which involves postural change from supine to sitting position, may be useful for observing autonomic nervous activity in the clinical setting. ABD carries the risk of imbalance of autonomic regulation. However, postphlebotomy infusion may reduce this imbalance.

摘要

目的

本研究旨在通过功率谱分析评估在自体献血(ABD)和采血后输液过程中,从仰卧位到坐位姿势改变(改良头高位倾斜试验[m-HUT])时自主调节的即时反应。

患者和方法

我们调查了37名在择期正颌手术前需要进行术前ABD的健康成年人。在ABD和采血后输液期间采用m-HUT进行测量。数据采用最大熵方法进行分析,仰卧位和倾斜位之间的差异通过方差分析确定。

结果

在静息状态下进行m-HUT时,心脏副交感神经活动显著降低,而心脏和血管交感神经活动显著增加。采血后进行m-HUT时,心脏副交感神经活动有增加趋势,而血管交感神经活动显著增加。在采血后输液期间未观察到这些变化。

结论

涉及从仰卧位到坐位姿势改变的m-HUT可能有助于在临床环境中观察自主神经活动。ABD存在自主调节失衡的风险。然而,采血后输液可能会减少这种失衡。

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