摘要
目的研究经食管超声心动图(TEE)与容量性肺动脉导管方法测定右心射血分数(RVEF)、右室舒张末期容量(RVEDV)和右室收缩末期容量(RVESV),进行同期比较验证右心容量参数的准确性。方法28例拟行不停跳冠状动脉搭桥术的病人,麻醉诱导后置入食管超声探头,经右颈内静脉置入容量性肺动脉导管。在TEE上,分别计算左室舒张末期容量(TLVEDV)、左室收缩末期容量(TLVESV)和左室射血分数(TLVEF);右室舒张末期容量(TRVEDV)、右室收缩末期容量(TRVESV)和右室射血分数(TRVEF)。同时记录Vigilance血液动力学监测仪的右室舒张末期容量(VRVEDV)、右室收缩末期容量(VRVESV)和右室射血分数(VRVEF)作为基础值。经外周静脉在10min内快速输入10ml/kg的6%羟乙基淀粉。快速输入后即刻记录上述参数。结果与基础值比较,给予容量负荷后即刻,(1)Vigilance监测:VRVEDV、VRVESV均增加(P<0·01);VRVEF的差异无显著意义;(2)TEE参数TRVEDV和TLVEDV均增加(P<0·01);TRVESV和TLVESV也增加(P<0·05);TRVEF和TLVEF的差异无显著意义。容量性肺动脉导管和TEE两种测量方法测定的RVEDV和RVESV均有良好相关性,RVEF的相关性较好。结论容量性肺动脉导管方法测定的右心容量参数RVEDV、RVESV和RVEF可以反映病人的容量状态的变化。
Objective To compare the accuracy of right ventricular volumetric parameters with volumetric pulmonary artery catheter and transesophageal echocardiography （TEE） in patients undergoing off-pump coronary artery bypass graft surgery （CABG）. Methods Twenty-eight patients undergoing elective CABG surgery without cardiopulmomary bypass. Right ventricular end-diastolic VoIume（TRVDV）, right ventricular end-systolic volume （TRVESV） and right ventricular eject fraction （TRVEF） were obtained with transesophageal echocardiography （TEE） and right ventricular enddiastolic volume（VReDV）, right ventrlcular end-systolic volume （VRVESV） and right ventricular eject fraction （VRVEV） were obtained using volumetric PAC after anesthetic induction （baseline） and after infusing 10 ml/kg 6% HES （after infusing） respectively. Results After fluids infusing, TRVEDV, VRVEDV, TRVESV and VRVESV increased significantly comparing with baseline. VRVEDV showed good correlation with TRVEDV, and VRVESV showed good correlation between TRwsv as well. Comparing with baseline, TRVEF and VRVEV increased, but not significant. Correlation between TRVEV and VRVEV was good. Conclusion In this clinical investigation, volumetric pulmonary artery catheter enabled accurate right ventricular volumetric parameters in patients undergoing off-pump CABG surgery.
出处
《临床麻醉学杂志》
CAS
CSCD
2006年第7期483-485,共3页
Journal of Clinical Anesthesiology
关键词
食管超声心动图
持续右心容量监测
右心容量参数
Transesophageal echocardiography
Continuous right heart volumetric monitoring
Right heart volumetric parameter
