| Japanese |
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| Title | 胸部大動脈手術麻酔管理における局所脳内酸素飽和度の有用性 |
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| Subtitle | |
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| Authors | 秋山潤根*, 奈良範子* |
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| Organization | *岩手医科大学医学部麻酔学教室 |
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| Journal | 循環制御 |
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| Volume | 20 |
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| Number | 1 |
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| Page | 80-85 |
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| Year/Month | 1999/ |
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| Article | 原著 |
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| Publisher | 日本循環制御医学会 |
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| Abstract | 「要旨」胸部大動脈人工血管置換術を施行したASA分類2〜3の患者75名のうち循環停止時間が40分以上の43名を対象とした. 麻酔中の局所脳内酸素飽和度(regional cerebral oxygen saturation, rSo2)を経時的に測定し, 術後脳機能障害との関係につき検討した. また, 同時に26例については内頸静脈球道血酸素飽和度(oxygen saturation of internal jugular venous blood, Sjvo2)を測定し, 術後脳機能障害およびrSo2との関連について検討した. その結果, rSo2は循環停止時間の経過と共に低下し, 循環停止の20分後には循環停止前値に比較して有意に低下した. 障害例の13例について見ると, 循環停止終了時のrSo2と循環停止時間の間には強い正の相関が見られた(Y=0.676x-10.631, R2=0.474p<0.05). 脳障害の有無を判別する判別分析では判別関数Y=0.79X1+0.08X2-0.77X3が得られ, Yが0.67より大きければ障害群に, 小さければ非障害群に群別された. SjvO2の変化と術後脳機能障害との間には相関は見られず, rSO2とSjvo2との間には特に関係は見られなかった. 以上よりrSo2は循環停止を伴う胸部大動脈人工血管置換術において術後の脳機能障害予防の有力な指標となる可能性が示唆された. |
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| Practice | 基礎医学・関連科学 |
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| Keywords | |
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| English |
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| Title | Cerebral Oxygenation Monitoring by Near-infrared Spectroscopy is Clinically Useful in Patients Undergoing Thoracic Aortic Surgery during Hypothermic Circulatory Arrest |
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| Authors | Junne Akiyama*, Noriko Nara* |
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| Authors(kana) | |
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| Organization | *Department of Anesthesiology, School of Medicine, Iwate Medical University |
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| Journal | Circulation Control |
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| Volume | 20 |
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| Number | 1 |
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| Page | 80-85 |
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| Year/Month | 1999/ |
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| Article | Original article |
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| Publisher | Japan Society of Circulation Control |
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| Abstract | We measured rSo2 during hypothemic circulatory arrest and evalutated it's clinical efficacy as a brain monitor by analyzing the relationship between rSo2 and postoperative brain dysfunction. We also compared its usefuIness with oxygen saturation of internal jugular venous blood (Sjvo2) in the same clinical setting. In 43 patients undergoing thoracic aortic surgery, rSo2 was measured by optical spectroscopy at the following points ; before circulatory arrest, 10, 20, 30, 40 min after circulatory arrest and at the end of circulatory arrest. In 26 patient Sjvo2 was masured. In the brain dysfunction group, rSo2 at the end point of circulatory arrest showed significantly lower than that of non-dysfunction group (P<0.05). The rSo2 at the end of circulatory arrest correlated positively with the duration of circulatory arrest in the brain dysfunction group (n=13, r=0.67, P<0.05). A discriminate analysis was conducted to detect brain dysfunction, and the following functional equation was established : Y=0.79X1 + 0.08X2 - 0.77X3. |
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| Practice | Basic medicine |
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| Keywords | rSo2, Sjvo2, Deep hypothermic circulatory arrest, Brain dysfunction, Major vasucular surgery |
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