使用脑血氧仪对颈动脉内膜切除术分流放置的影响。
The effect of cerebral oximeter use on the shunt placement concerning carotid endarterectomy surgery.
作者信息
Ceyhan Dilek, Ovali Cengiz
机构信息
Department of Anesthesiology and Reanimation, Eskisehir Osmangazi University Medical Faculty, Eskisehir, Turkey.
Department of Cardiac and Vascular Surgery, Eskisehir Osmangazi University Medical Faculty, Eskisehir, Turkey.
出版信息
Ann Card Anaesth. 2019 Apr-Jun;22(2):158-161. doi: 10.4103/aca.ACA_57_18.
BACKGROUND
During carotid arterial endarterectomy (CAE) surgery, an intraluminal shunt is used to prevent hypoperfusion, which can be caused by a cross-clamping cerebral ischemia. However, routine shunt use is not recommended. Various cerebral monitoring techniques are used to determine the need for shunt placement. In this study, retrospective analysis of data on the efficacy of cerebral oximetry in the decision of shunt use during elective CAE surveys was planned.
MATERIALS AND METHODS
We collected data on 68 patients operated under general anesthesia between December 2016 and December 2017. Patients were evaluated for near infrared spectrometry (NIRS) and stump pressure values and whether shunt was placed or not.
RESULTS
Eight (11.7%) patients were shunting. NIRS value after cross-clamping was lower in patients with shunt. Stump pressure values were below 40 mmHg.
CONCLUSIONS
Cerebral monitoring in elective CAE operations has great importance in determining the necessity of using intraluminal shunt to reduce the complications that may occur.
背景
在颈动脉内膜切除术（CAE）手术期间，腔内分流器用于预防可能由交叉夹闭脑缺血引起的灌注不足。然而，不建议常规使用分流器。各种脑监测技术用于确定是否需要放置分流器。在本研究中，计划对择期CAE手术期间脑血氧饱和度测定在分流器使用决策中的疗效数据进行回顾性分析。
材料与方法
我们收集了2016年12月至2017年12月期间在全身麻醉下接受手术的68例患者的数据。对患者进行近红外光谱（NIRS）和残端压力值评估，以及是否放置分流器。
结果
8例（11.7%）患者使用了分流器。使用分流器的患者交叉夹闭后的NIRS值较低。残端压力值低于40 mmHg。
结论
在择期CAE手术中进行脑监测对于确定使用腔内分流器以减少可能发生的并发症的必要性具有重要意义。
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