摘要
目的探讨经食道超声多普勒对腹部大手术中液体治疗的价值。方法96例择期腹部大手术患者，随机分成经食道超声多普勒指导输液组（ODM组，n,=49）和对照组（C组，n,=47）。比较两组液体量、尿量、平均动脉压、心率、入ICU时动脉血乳酸、B型利钠肽及术后7d并发症。结果ODM组术中输液总量[（5651．5±561．8）ml比（5423．8±542．3）ml，P〈0．05]、尿量[（376．5±99．6）rnl比（228．9±68．2）ml，P〈0．01]明显增加。手术结束时ODM组平均动脉压[（80．3±8．2）ramHg（1mmHg=0．133kPa）比（70．0±5．1）mmHg，P〈0．01]明显高于对照组，两组问心率差异无统计学意义（P〉0．05）。术后入ICU时，ODM组乳酸[（1．9±0．3）mmol／L比（3．8±1。1）mmol／L，P〈0．01]显著低于C组，而B型利钠肽[（84．9±17．2）ng／L比（81．2±10．9）ng/L，P〉0．05]两组间差异无统计学意义（P〉0．05）。术后并发症两组间差异有统计学意义（P〈0．05）。结论经食道超声多普勒指导术中液体治疗可改善组织氧供，降低术后并发症。
Objective To investigate the significance of transesophageal Doppler monitoring for fluid therapy in patients undergoing major abdominal surgery. Methods Ninety-six patients undergoing major abdominal surgery were randomly assigned into transesophageal Doppler monitoring group （ODM group,n =49） and control group （ C group,n =47）. Fluid volume, urine volume, mean arteria/pressure and heart rate, lactic acid and B-type natriuretic peptide at ICU admission and complications 7 days after surgery were compared between two groups. Results Fluid volume [ （5651.5 ± 561.8 ） ml vs. （5423.8 ±542. 3） ml,P 〈0.05], urine volume [ （376. 5 ＋99.6） ml vs. （228. 9 ±68.2） ml,P 〈0. O1 ] in ODM group significantly increased as compared with control group. At the end of operation, mean arteri- al pressure [（80.3±8.2） mmHg（1 mmHg=O. 133kPa） vs. （70.0±5.1） mmHg,P〈0.01] was higher in ODM group than that in control group, hut no significant difference was found in heart rate between groups （ P 〉 0.05 ）. Lactic acid [ （ 1.9 ±0. 3 ） mmol/L vs. （ 3.8 ± 1.1 ） mmol/L,P 〈 0. 01 ] at ICU admission was markedly lower in ODM group than that in control group, but BNP showed no significant difference between groups. At 7th day after surgery, incidence of complications was lower in ODM group than that in control group. Conclusion Fluid therapy was guided with ODM, which could improve tissue oxygenation and low complication after surgery.
出处
《中华实验外科杂志》
CAS
CSCD
北大核心
2013年第4期826-828,共3页
Chinese Journal of Experimental Surgery
基金
武汉市晨光计划资助项目（201050231063）
关键词
经食道超声多普勒
腹部大手术
液体治疗
每搏输出量
Transesophageal doppler monitoring
Major abdominal surgery
Fluid therapy
Stroke volume
