中华麻醉学杂志
中華痳醉學雜誌
중화마취학잡지
CHINESE JOURNAL OF ANESTHESIOLOGY
2011年
1期
13-16
,共4页
曲瑶%于高起%韩伟%麻海春
麯瑤%于高起%韓偉%痳海春
곡요%우고기%한위%마해춘
低温,人工%诱发电位,躯体感觉
低溫,人工%誘髮電位,軀體感覺
저온,인공%유발전위,구체감각
Hypothermia,induced%Evoked potentials,somatosensory
目的 评价低体温对患者体感诱发电位(SSEP)的影响.方法 择期心脏手术患者13例,性别不限,年龄23～51岁,体重45～82 kg,ASA分级Ⅱ或Ⅲ级.麻醉诱导后测定双侧正中神经体感诱发电位:于Erb点和第2颈椎棘突分别放置臂丛和颈部记录电极,随后放置头皮电极,分别记录臂丛电位(N9)、颈髓电位(N13)和皮层电位(N20)的峰潜伏期和波幅.记录降温阶段和复温阶段达到目标体温(36、35、34、33 ℃)时的MAP、峰潜伏期和波幅.术后记录显性神经功能缺陷的发生情况.结果 降温阶段随体温降低,峰潜伏期延长,MAP降低(P＜0.05),波幅差异无统计学意义(P＞0.05);复温阶段随体温升高,峰潜伏期缩短(P＜0.05),MAP和波幅差异无统计学意义(P＞0.05);降温阶段峰潜伏期与体温呈负相关,相关系数分别为-0.673(N9)、-0.702(N13)、-0.702(N20)(P＜0.05),以体温为自变量X,峰潜伏期为因变量Y,得到直线回归方程分别为:Y9=-0.558X+28.994,YN13=-1.121X+53.242,YN20=-1.458X+72.036;复温阶段峰潜伏期与体温呈负相关,相关系数分别为-0.634(N9)、-0.619(N13)、-0.600(N20)(P＜0.05),直线回归方程分别为:YN9=-0.505X+27.313,YN13=-0.905X+46.249,YN20=-1.142X+61.668.所有患者术后均未发生神经系统功能缺陷.结论 低体温可延长SSEP峰潜伏期,对波辐无明显影响.
目的 評價低體溫對患者體感誘髮電位(SSEP)的影響.方法 擇期心髒手術患者13例,性彆不限,年齡23～51歲,體重45～82 kg,ASA分級Ⅱ或Ⅲ級.痳醉誘導後測定雙側正中神經體感誘髮電位:于Erb點和第2頸椎棘突分彆放置臂叢和頸部記錄電極,隨後放置頭皮電極,分彆記錄臂叢電位(N9)、頸髓電位(N13)和皮層電位(N20)的峰潛伏期和波幅.記錄降溫階段和複溫階段達到目標體溫(36、35、34、33 ℃)時的MAP、峰潛伏期和波幅.術後記錄顯性神經功能缺陷的髮生情況.結果 降溫階段隨體溫降低,峰潛伏期延長,MAP降低(P＜0.05),波幅差異無統計學意義(P＞0.05);複溫階段隨體溫升高,峰潛伏期縮短(P＜0.05),MAP和波幅差異無統計學意義(P＞0.05);降溫階段峰潛伏期與體溫呈負相關,相關繫數分彆為-0.673(N9)、-0.702(N13)、-0.702(N20)(P＜0.05),以體溫為自變量X,峰潛伏期為因變量Y,得到直線迴歸方程分彆為:Y9=-0.558X+28.994,YN13=-1.121X+53.242,YN20=-1.458X+72.036;複溫階段峰潛伏期與體溫呈負相關,相關繫數分彆為-0.634(N9)、-0.619(N13)、-0.600(N20)(P＜0.05),直線迴歸方程分彆為:YN9=-0.505X+27.313,YN13=-0.905X+46.249,YN20=-1.142X+61.668.所有患者術後均未髮生神經繫統功能缺陷.結論 低體溫可延長SSEP峰潛伏期,對波輻無明顯影響.
목적 평개저체온대환자체감유발전위(SSEP)적영향.방법 택기심장수술환자13례,성별불한,년령23～51세,체중45～82 kg,ASA분급Ⅱ혹Ⅲ급.마취유도후측정쌍측정중신경체감유발전위:우Erb점화제2경추극돌분별방치비총화경부기록전겁,수후방치두피전겁,분별기록비총전위(N9)、경수전위(N13)화피층전위(N20)적봉잠복기화파폭.기록강온계단화복온계단체도목표체온(36、35、34、33 ℃)시적MAP、봉잠복기화파폭.술후기록현성신경공능결함적발생정황.결과 강온계단수체온강저,봉잠복기연장,MAP강저(P＜0.05),파폭차이무통계학의의(P＞0.05);복온계단수체온승고,봉잠복기축단(P＜0.05),MAP화파폭차이무통계학의의(P＞0.05);강온계단봉잠복기여체온정부상관,상관계수분별위-0.673(N9)、-0.702(N13)、-0.702(N20)(P＜0.05),이체온위자변량X,봉잠복기위인변량Y,득도직선회귀방정분별위:Y9=-0.558X+28.994,YN13=-1.121X+53.242,YN20=-1.458X+72.036;복온계단봉잠복기여체온정부상관,상관계수분별위-0.634(N9)、-0.619(N13)、-0.600(N20)(P＜0.05),직선회귀방정분별위:YN9=-0.505X+27.313,YN13=-0.905X+46.249,YN20=-1.142X+61.668.소유환자술후균미발생신경계통공능결함.결론 저체온가연장SSEP봉잠복기,대파복무명현영향.
Objective To evaluate the effect of hypothermia on somatosensory evoked potentials (SSEPs). Methods Thirteen ASA Ⅱ or Ⅲ patients aged 23-51 yr weighing 45-82 kg scheduled for cardiac surgery were enrolled in this study. Bilateral median nerve SSEPs (N9, N13, N20) were recorded after induction.The MAP, peak latency and amplitude of N9, N13 and N20 were recorded when the target temperature (36, 35,34, 33 ℃ ) was reached during the cooling and rewarming periods. The neurological dysfunction was recorded after operation. Results The peak latency was prolonged and MAP was decreased with the decrease in the body temperature during the cooling period, the peak latency was shortened with the increase in the body temperature during the rewarming period ( P ＜ 0.05), but no significant change in the amplitudes was found ( P ＞ 0.05). The regression equation of the interaction between the peak latency and body temperature was YN9= -0.558X + 28.994(r=-0.673), YN13 =-1.121X+53.242 (r= -0.702) , YN20 = -1.458X+72.036(r= -0.702) during the cooling period (P ＜ 0.05), and YN9 = - 0.505X + 27.313 ( r = - 0.634), YN13 = - 0.905X + 46.249(r= -0.619), YN20 = - 1.142X + 61.668 (r= -0.600) during the rewarming period (P ＜0.05). No neurological dysfunction was found in all the patients. Conclusion Hypothermia can prolong the peak latency of SSEP and does not alter the SSEP amplitude.
