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经颅多普勒超声成像虽能检测脑灌注或脑血流速度,但却不能定量测定脑血流量(CBF),尤其是蛛网膜下腔出血和血管痉挛时,脑血流速度呈反常性增快,而实际脑血流量却减少。习用的惰性气或水载放射性示踪弥散液体等测量脑血流量方法,虽精确但太复杂,不适合床边监测。近年来,应用光导纤维导管置入颈静脉球部(jugular bulb),注冷冻吲哚菁绿溶液,用温度/染料双指示剂稀释技术(TCID)可测定脑血流量。作者为了给病人在床边使用TCID监测血流量并与用惰性气体的Kety-Schmidt法比较,特选择拟行冠脉搭桥术的14例病人进行研究。该14例的平均年龄60岁(49～71岁),体重(84±9)kg,身高(176±6)cm,术前作动脉和中心静脉置管。注芬太尼、咪达唑仑和潘库溴铵后行气管插管,静
Although transcranial Doppler ultrasound imaging can detect cerebral perfusion or cerebral blood flow velocity, but can not quantitatively determine cerebral blood flow (CBF), especially in subarachnoid hemorrhage and vasospasm, cerebral blood flow rate was abnormal increase Fast, but the actual cerebral blood flow decreased. Conventional inert gas or water-based radioactive tracer dispersion liquid measurement of cerebral blood flow method, although accurate but too complicated, is not suitable for bedside monitoring. In recent years, optical fiber catheters were implanted into the jugular bulb, and indocyanine green solution was injected to freeze. The cerebral blood flow was measured by TCID. The authors selected 14 patients who had undergone coronary artery bypass grafting in order to monitor their blood flow at the bedside using TCID and compared with the Kety-Schmidt method using inert gas. The mean age of these 14 patients was 60 years old (49-71 years old), weighing (84 ± 9) kg and height (176 ± 6) cm. The artery and central venous catheter were placed before surgery. Fentanyl, midazolam and pancuronium after tracheal intubation, static