摘要
目的:探讨FloTrac/vigileo用于电视胸腔镜下小儿漏斗胸微创矫形术(NUSS术)中观察手术操作步骤对患儿血流动力学变化的敏感性。方法:观察60例全麻下行NUSS手术的漏斗胸患儿,使用FloTrac/vigileo监测并记录:机械通气时(T1)、手术开始时(T2)、胸腔镜充气时(T3)、矫形板植入时(T4)、胸腔镜放气时(T5)各时点CO、CI、SV、SVV变化值。结果:与T1比较,T2时CO、CI、SV、SVV无明显变化,差异无统计学差异(P>0.05);与T1相比较,T3、T5时CO、CI下降,差异有统计学意义(P<0.05);T4时SV、SVV下降,T5时SV、SVV上升,差异有统计学意义(P<0.05)。结论:NUSS手术过程中胸腔镜充气、矫形板植入、退镜排气等操作对漏斗胸患儿心输出量、心脏指数、每搏量及每搏量变异度均产生不同程度影响,FloTrac/vigileo能准确迅速的反应其变化,为正确、及时的麻醉处理提供依据。
Objective ：To investigate the sensitivity of FloTrac/vigileo system in hemodynamic changes by operation steps of the children with funnel chest minimally invasive video-assisted thoracoscope orthopedics （NUSS） .Methods ：Monitoring 60 cases of NUSS procedure under the FloTrac/vigileo system to record the change value of CO ,CI ,SV , SVV on each point below ：at the time of mechanical ventilation （T1 ） ,at the beginning of the operation （T2 ） ,at the time of the thoracoscope in flatable （T3 ） ,at the time of the orthopedic plate implantation （T4 ） ,at the beginning of the thoracoscope deflatecd （T5 ） .Results：Compared with T1 ,CO ,CI ,SV ,SVV in T2 have no obvious change ,But in T3 and T5 points ,CO ,CI decreased obviously ,changes had statistical significance （P〈 0 .05）;SV SVV dropped in T4 ;but rosed in T5 ,changes had statistical significance（P〈0 .05） .Conclusion：NUSS operation steps such as thoracoscope inflatable ,orthopedic plate implantation ,thoracoscope deflated etc could influence CO ,CI ,SV ,SVV of children with funnel chest .The FloTrac/vigileo could rapidly response the change ,provide timely and effective anesthesia processing ba-sis .
出处
《医学理论与实践》
2014年第22期2959-2960,2977,共3页
The Journal of Medical Theory and Practice
