Konishi A, Kikuchi K
Department of Anesthesia, New Tokyo Hospital, Matsudo.
Masui. 1995 Oct;44(10):1322-6.
We studied the occurrence of brain dysfunction in regards to changes in cerebral oxygen saturation (rSo2) during open heart surgery. The subjects were 68 patients with the average age of 61 years. For the evaluation of brain function, Hasegawa Dementia Scale was used, and those patients whose scores were less than 23 points, or had decreased by more than 3 points from preoperative scores on the 7th postoperative day were categorized as the brain dysfunction group. There were 14 (21%) postoperative brain dysfunction cases. Although rSo2 values during surgery ran at 70-65% level, the brain dysfunction group showed significantly lower values throughout the entire procedures, with the lowest value being 61% during cardiopulmonary bypass. The patients in the dysfunction group were of older ages and postoperative lower cardiac index, which indicated that the occurrence of brain dysfunction is greatly influenced by low cerebral blood flow. Effect from the operative procedures and CPB alone seemed to be small. Cerebral oxygen saturation (rSo2) is believed to be a useful monitor of cerebral blood flow, and occurrence of brain dysfunction may be expected at values lower than 60%.
我们研究了心脏直视手术期间脑氧饱和度（rSo2）变化与脑功能障碍发生情况之间的关系。研究对象为68例平均年龄61岁的患者。采用长谷川痴呆量表评估脑功能，术后第7天得分低于23分或较术前得分下降超过3分的患者被归为脑功能障碍组。术后有14例（21%）发生脑功能障碍。尽管手术期间rSo2值维持在70%-65%水平，但脑功能障碍组在整个手术过程中rSo2值显著更低，在体外循环期间最低值为61%。功能障碍组患者年龄较大且术后心脏指数较低，这表明脑功能障碍的发生受脑血流量低的影响很大。仅手术操作和体外循环的影响似乎较小。脑氧饱和度（rSo2）被认为是监测脑血流量的有用指标，rSo2值低于60%时可能会发生脑功能障碍。
