体外循環離脱後の前額部—足底部深部温度較差の意義—IABP併用および部分体外循環法との比較

Measurements of deep body temperature difference after cardio-pulmonary bypass:Effects of non-pulsatile, pulsatile flow on peripheral circulation

　前額部深部温度を中枢温度（中心循環血液温度）とし，足底部深部温度を末梢温度とした中枢—末梢深部温度較差の測定は，心筋梗塞後，重症弁膜症あるいは心筋症の心不全治療や，開心術後の循環管理において，末梢循環面の指標として有用な方法である。

　この中で，開心術後の深部温度較差の測定は，生体が一旦，体外循環という非生理的環境下にさらされる点において，その術後の深部温度較差は一連の特徴あるいは推移を示す^1,2）。今回，大動脈バルーンパンピング（IABP）併用を含めた開心術症例と悪性腫瘍に対する人工心肺を使った全身温熱療法症例を対象に，手術後カテコラミンの投与なしにボリューム管理のみを行なった自然経過例の深部温度較差の推移を比較検討した。

Deep body temperature difference (DBTD) be-tween the forehead and the sole of foot were meas-ured in the three groups to evaluate the effects on peripheral circulation in the non-pulsatile and pulsatile flow during the cardio-pulmonary bypass (CPB).

Group 1 was six valvular surgeries under non-pulsatile flow in CPB. Group 2 was three valvular surgeries and two A-C bypass surgeries under pul-satile flow by intra-aortic balloon pumping in CPB. Group 3 was six hyperthermias for malignant tumor. This group was controled by the partial CPB.

Similar patterns were obtained in each groups, which were influenced by the damage of peripheral circulation in CPB and its normalization after CPB. IABP might minimize the damage of peripheral circulation in CPB and maintain the good peri-pheral circulation after CPB.