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慢性肺动脉血栓栓塞症患者手术各阶段的脑氧供应

Oxygen provision of the brain at various stages of operation in patients with chronic pulmonary artery thromboembolism.

作者信息

Kamenskaia O V, Klinkova A S, Cherniavskiĭ A M, Cherniavskiĭ M A, Kalinin R A, Karas'kov A M

机构信息

Novosibirsk Scientific Research Institute of Circulatory Pathology named after Academician E.N. Meshalkin under the RF Ministry of Public Health, Novosibirsk, Russia.

出版信息

Angiol Sosud Khir. 2015;21(1):13-22.

Abstract

The authors studied cerebral oxygen supply by means of cerebral oximetry in patients presenting with chronic pulmonary artery thromboembolism (PATE) at various stages of operation. The study was aimed at assessing cerebral oxygen supply while carrying out surgical treatment in patients with chronic PATE on the background of various methods of perfusion. Thromboendarterectomy (TEA) from the pulmonary artery with the use of circulatory arrest and craniocerebral hypothermia is accompanied by more pronounced impairment of oxygen supply of the brain with a decrease in the cerebral oxygenation indices by more than 30% from the baseline values. These alterations promote increased risk for the development of neurological complications in the early postoperative period. Using the technique of antegrade cerebral perfusion ensures a minimum decrease of cerebral oxygenation during TEA and contributes to a reduction of the risk for the development of neurological complications.

摘要

作者通过脑血氧饱和度测定法研究了处于不同手术阶段的慢性肺动脉血栓栓塞症(PATE)患者的脑氧供应情况。该研究旨在评估在各种灌注方法背景下,对慢性PATE患者进行手术治疗时的脑氧供应情况。使用循环停止和颅脑低温技术进行肺动脉血栓内膜切除术(TEA)时,脑氧供应受损更为明显,脑氧合指数较基线值降低超过30%。这些变化增加了术后早期发生神经并发症的风险。采用顺行性脑灌注技术可确保TEA期间脑氧合的最小程度降低,并有助于降低发生神经并发症的风险。

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