摘要
目的 :应用经食管超声多普勒血液动力学监测仪 ,观察液体治疗时每搏量 (SV)与全身血管阻力 (TSVR)的变化 ,并分析两者的相关性 .方法 :36例 2 9～ 5 7岁 ,ASAI～II级、择期行非心脏手术患者随机分为对照组和治疗组 .麻醉诱导插管后将超声探头经口放入食管 ,探头位置位于第三四肋间隙 (或第五六胸椎间隙 ) ,用HemosonicTM1 0 0血液动力学监测仪监测SV ,每隔 5min输入一次平均动脉压 (MAP)值后 ,再计算得出的TSVR值 .待麻醉平稳和各项监测设置完成后 1 0min ,记录各项监测参数 ,然后经已建立的静脉通路给对照组缓慢输入平衡盐液 ,治疗组在 2 0min内快速输入 5 0 0mL的羟乙基淀粉 (6 0 g·L -1 贺斯 ,2 0 0 / 0 .5 ,德国 ,费森尤斯公司生产 ) ,观察并记录液体输毕时患者血液动力学和TSVR的变化 .结果 :对照组血液动力学和TSVR无明显变化 ,而治疗组MAP、心输出量 (CO)和SV明显升高 ,TSVR显著降低 ,HR输入前后无明显变化 ,TSVR与SV之间具有高度相关性 ,相关系数r =- 0 .72 (P <0 .0 1 ) .结论
AIM: To monitor the changes of total systemic vascular resistance (TSVR) and stroke volume (SV) during fluid therapy by transesophageal echo Doppler and to explore the correlation between TSVR and SV. METHODS: Thirty six ASA I-II patients undergoing elective non cardiac surgery were included in this study. The anesthetic management was standardized for all patients. After induction of anesthesia and tracheal intubation, the transesophageal echo Doppler probe was placed in the esophagus at the level of T 5-6 vertebra. The probe faced backward toward descending aorta and homodynamic variables were obtained. In addition, mean arterial blood pressure (MAP) was entered every 5 min to derive TSVR values. Balanced salt solution was slowly infused into patients in the control group and 500 mL hydroxyethyl starch (60 g·L -1 HAES Steril 200/0.5) was quickly infused within 20 min into patients in the treatment group. RESULTS: In control group, no changes of hemodynamics and TSVR were found. After quick infusion of 500 mL HES, MAP, cardiac output (CO) and SV increased significantly while TSVR decreased markedly ( P <0.05) and HR remained unchanged compared with that pre infusion. The changes in TSVR and SV within 30 min of probe placement were highly correlated ( r = -0.72, P <0.01). CONCLUSION: Transesophageal echo Doppler shows that increases in TSVR tend to produce reductions in SV during fluid therapy.
出处
《第四军医大学学报》
北大核心
2003年第15期1402-1404,共3页
Journal of the Fourth Military Medical University
基金
第四军医大学西京医院创新课题资助 (2 0 0 2 38)
关键词
超声多普勒
心输出量
全身血管阻力
echo Doppler
cardiac output
total systemic vascular resistance
