摘要目的 建立孕羊体外循环过程中胎羊有创监测模型,探讨母体体外循环对胎儿温度、血流动力学的影响.方法 20头健康孕羊随机分为对照组、常温组、浅低温组和中低温组4组,每组5头.常规建立体外循环,转流降温.监测孕羊和胎羊的温度、心率、平均动脉压.结果 中低温组1头孕羊转流后发生室颤导致孕羊和胎羊死亡.降温期胎羊温度始终高于孕羊的温度.复温期孕羊、胎羊温度回升,转流结束后胎羊温度低于孕羊温度.降温期胎羊心率逐渐减慢,血压下降,复温期逐渐恢复正常.结论 母体体外循环影响胎儿温度、血压和心率,但变化是可逆的.母体常温或浅低温体外循环对胎儿的影响最小,临床上可以安全应用.

abstractsObjective To establish animal model for invasive monitoring in fetus during maternal cardiopulmonary bypass and to evaluate fetal-maternal temperature relationship and fetal cardiovascular response during maternal cardiopulmonary bypass in preg- nant ewes. Methods The atemal cardiopulmonary bypass was established, reaching different levels of maternal hypothennia. 20 pregnant ewes were divided into 4 groups, including normothermic group, mild hypothennic group, moderate hypothennic group and control group. Hypothermic levels were maintained for 20 minutes, then the rewarming phase was started. Fetal and maternal tempera- tare, blood pressure, heart rate were evaluated at different levels of hypothermia and during recovery. Results One ewe died of ven-tricular filbrillation in moderate hypothermi group, and the other ewes and fetuses survived. Maternal temperature was always lower than fetal temperature during cooling; during rewarming the gradient was inverted. The start of cardiopulmonary bypass and cooling was associated with transient fetal tachycardia; then, both fetal heart rate and blood pressure progressively decreased. Conclusion Ma-ternal hypothennic cardiopulmonary bypass was associated with reversible modifications in fetal temperature, cardiovascular parame-ters. The application of normothermic or mild hypothennic perfusion is safe to the fetus and mother.