本文選題：超聲造影 + 體外循環(huán)��； 參考：《四川大學(xué)學(xué)報(醫(yī)學(xué)版)》2015年06期

【摘要】：目的探討體外循環(huán)轉(zhuǎn)流對成人腎臟微循環(huán)灌注的影響。方法納入擇期行體外循環(huán)心臟手術(shù)成人患者6例和非心臟手術(shù)的成人患者12例,分別于體外循環(huán)建立30min和麻醉誘導(dǎo)結(jié)束生命體征穩(wěn)定5min后獲取腎臟超聲造影圖像,采用超聲造影技術(shù)分析比較成人非搏動性體外循環(huán)與麻醉誘導(dǎo)后的腎臟微循環(huán)灌注。分析比較兩種條件下腎臟不同區(qū)域的灌注時間強(qiáng)度曲線(TIC)的相關(guān)參數(shù):上升支斜率(α)、達(dá)峰時間(TTP)、峰值強(qiáng)度(PI)、曲線下面積(AUC)。結(jié)果與全身麻醉狀態(tài)相比,體外循環(huán)下腎臟淺層皮質(zhì)、深層皮質(zhì)和髓質(zhì)錐體區(qū)域TIC的AUC均降低(P0.05),體外循環(huán)組腎臟髓質(zhì)區(qū)域AUC低于同條件下的淺層皮質(zhì)以及深層皮質(zhì)的AUC(P0.05)。所有患者均未出現(xiàn)超聲微泡造影劑相關(guān)的不良事件。結(jié)論體外循環(huán)下腎臟各個區(qū)域的微循環(huán)灌注出現(xiàn)了明顯下降,其中以髓質(zhì)區(qū)域下降最為明顯。超聲造影技術(shù)可用于監(jiān)測心臟手術(shù)期間腎臟微循環(huán)灌注狀態(tài)。
[Abstract]:Objective to investigate the effect of cardiopulmonary bypass (CPB) on renal microcirculation perfusion in adults. Methods six adult patients undergoing cardiopulmonary bypass (CPB) and 12 adults undergoing non-cardiac surgery were enrolled in this study. Renal contrast-enhanced imaging was obtained after cardiopulmonary bypass (CPB) and anesthesia induction (30min) and stable vital sign (5min) after anesthesia induction. Contrast-enhanced ultrasonography was used to analyze and compare the renal microcirculation perfusion between adult non-pulsatile cardiopulmonary bypass and anesthetic induction. The parameters of perfusion time intensity curve (TIC) in different areas of kidney under two conditions were analyzed and compared: slope of ascending branch (偽), peak time (TTP), peak intensity (Pi), area under curve (AUC). Results compared with general anesthesia, the AUC of TIC in the superficial cortex, deep cortex and medullary pyramidal area of the CPB group was lower than that in the superficial cortex and deep cortex under cardiopulmonary bypass (P0.05), and the AUC in the medullary area of the kidney in the CPB group was lower than that in the superficial cortex and deep cortex under the same condition (P0.05). No adverse events related to ultrasound microbubbles were found in all patients. Conclusion under cardiopulmonary bypass (CPB), the microcirculation perfusion in various areas of the kidney decreased significantly, especially in the medullary area. Contrast-enhanced ultrasonography can be used to monitor renal microcirculation during cardiac surgery.
【作者單位】： 四川大學(xué)華西醫(yī)院麻醉科;四川大學(xué)華西醫(yī)院超聲科;四川大學(xué)華西醫(yī)院心外科;
【基金】：四川省科技廳科技支撐計劃項目(No.2012FZ0121)資助
【分類號】：R614

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1 鐘曉緋;朱達(dá);盧強(qiáng);劉斌;彭玉蘭;;超聲造影監(jiān)測兒童及嬰幼兒體外循環(huán)下腎臟微循環(huán)灌注的初探[J];四川大學(xué)學(xué)報(醫(yī)學(xué)版);2013年04期

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