CAJ | 학술논문

目的评价胸腔阻抗(TEB)无创血流动力学监测在非心脏手术老年患者全麻术后的应用价值.方法选取收治于ICU的非心脏手术全麻术后老年患者56例,按照随机数字表法分为对照组和TEB组,每组28例,所有患者均给予常规监护并监测中心静脉压,TEB组在上述基础上行TEB无创血流动力学监测,根据监测结果给予利尿药、正性肌力药、血管扩张剂或补液治疗;比较两组患者心率、平均动脉压、中心静脉压、尿量以及机械通气时间、住ICU时间.结果两组患者同一时间相应的心率、平均动脉压、中心静脉压、尿量比较差异均无统计学意义(P＞0.05).机械通气时间TEB组患者为(19.5±15.9)h,较对照组的(25.5±16.5)h缩短,但差异无统计学意义(P=0.173);住ICU时间TEB组患者为(2.8±1.0)d,较对照组的(3.6±1.6)d缩短,且差异有统计学意义(P=0.032).结论 TEB无创血流动力学监测对非心脏手术老年患者全麻术后的治疗具有指导作用,有利于患者的术后恢复.
목적 평개흉강조항(TEB)무창혈류동역학감측재비심장수술노년환자전마술후적응용개치.방법 선취수치우ICU적비심장수술전마술후노년환자56례,안조수궤수자표법분위대조조화TEB조,매조28례,소유환자균급여상규감호병감측중심정맥압,TEB조재상술기출상행TEB무창혈류동역학감측,근거감측결과급여이뇨약、정성기력약、혈관확장제혹보액치료;비교량조환자심솔、평균동맥압、중심정맥압、뇨량이급궤계통기시간、주ICU시간.결과 량조환자동일시간상응적심솔、평균동맥압、중심정맥압、뇨량비교차이균무통계학의의(P＞0.05).궤계통기시간TEB조환자위(19.5±15.9)h,교대조조적(25.5±16.5)h축단,단차이무통계학의의(P=0.173);주ICU시간TEB조환자위(2.8±1.0)d,교대조조적(3.6±1.6)d축단,차차이유통계학의의(P=0.032).결론 TEB무창혈류동역학감측대비심장수술노년환자전마술후적치료구유지도작용,유리우환자적술후회복.
Objective To evaluate the application value of non-invasive hemodynamic monitoring by thoracic electrical bioimpedance (TEB) in elderly non-cardiac surgery patients after general anaesthesia.Methods Fifty-six elderly non-cardiac surgery patients after general anaesthesia were divided into control group and TEB group with 28 patients in each group by random digits table. All patients received standardized care including central venous pressure (VAP). Besides these monitoring, hemodynamic monitoring by TEB was used to evaluate the hemodynamic state of patients in TEB group. Diuretics, inotropic agents, vasoactive drugs or intravenous fluid therapy were used according to monitoring guidance. The heart rate (HR), mean arterial pressure (MAP), VAP, urine output (UO) were recorded in different time. The length of mechanical ventilation and ICU stay were also recorded. The difference in HR, MAP, VAP, UO, the length of mechanical ventilation and ICU stay between two groups were analyzed. Results The differences between two groups had no significance in HR, MAP, VAP, UO at the same time (P ＞ 0.05 ). The length of mechanical ventilation of TEB group [ (19.5±15.9)h] was shorter as compared to that of control group [ (25.5 ± 16.5) h ], but the difference was not significant (P =0.173). The ICU stay of TEB group [(2.8 ± 1.0) d ] was shorter as compared to that of control group[(3.6±1.6)d] and the difference was significant (P=0.032). Conclusion Non-invasive hemodynamic monitoring by TEB can monitor the changes of hemodynamics and direct treatment in elderly non-cardiac surgery patients after general anaesthesia.