CAJ | 학술논문

目的应用每搏量变异指数（stroke volume variations, SVV）评价单次输入20%甘露醇对行幕上肿瘤切除术患者血管内容量的影响。方法随机选取ASAⅠ~Ⅱ级40例全麻下择期行幕上肿瘤切除术的患者，男19例，女21例；年龄18~65岁；BMI为18～25 kg/m2。术中打开硬脑膜之前单次输入20%甘露醇1 g/kg，10 min以上输完。于甘露醇开始输入即刻记录心率（HR）、平均动脉压（MAP）、心排血量（CO）、SVV等指标，此后每5 min记录1次，连续记录1 h。结果单次输入20%甘露醇后，SVV数值在开始输入后10～20 min内明显下降（血管内容量明显增加），随后SVV数值逐渐回升（P<0.05）；CO在开始输入后15～30 min内明显上升，随后逐渐下降（P<0.05）；MAP和HR在输入后则没有明显变化（P>0.05）。结论单次输入20%的甘露醇后，血管内容量会出现短暂而明显的增加，SVV可准确地反映这一变化，为临床工作提供准确的评估依据。
목적응용매박량변이지수（stroke volume variations, SVV）평개단차수입20%감로순대행막상종류절제술환자혈관내용량적영향。방법수궤선취ASAⅠ~Ⅱ급40례전마하택기행막상종류절제술적환자，남19례，녀21례；년령18~65세；BMI위18～25 kg/m2。술중타개경뇌막지전단차수입20%감로순1 g/kg，10 min이상수완。우감로순개시수입즉각기록심솔（HR）、평균동맥압（MAP）、심배혈량（CO）、SVV등지표，차후매5 min기록1차，련속기록1 h。결과단차수입20%감로순후，SVV수치재개시수입후10～20 min내명현하강（혈관내용량명현증가），수후SVV수치축점회승（P<0.05）；CO재개시수입후15～30 min내명현상승，수후축점하강（P<0.05）；MAP화HR재수입후칙몰유명현변화（P>0.05）。결론단차수입20%적감로순후，혈관내용량회출현단잠이명현적증가，SVV가준학지반영저일변화，위림상공작제공준학적평고의거。
Objective To investigate whether Stroke Volume Variations (SVV) can evaluate intravascular volume changes induced by a bolus of 20%mannitol during elective supratentorial craniotomy. Methods Forty adult patients with grade Ⅰ and Ⅱ ASA were underwent elective supratentorial craniotomy and received 20% mannitol (1 g/kg) over 10 minutes before the dural was opened. The following hemodynamic parameters were recorded at the moment of infusion and every 5 minutes after administration of mannitol:heart rate (HR), mean arterial pressure (MAP), SVV, cardiac output (CO), and urine volume. Resutls SVV significantly decreased at 10 minutes after mannitol infusion and remained in-significantly decline till 20 minutes, then returned to baseline values (P< 0.05). CO increased significantly at 15 minutes (P < 0.05) and remained insignificantly elevated till 30 minutes. There were no remarkable changes in HR and MAP throughout the study period (P>0.05). Conclusion In patients undergoing supratentorial craniotomy, it has been demon-strated that a single bolus dose of 20%mannitol (1g/kg) causes significant but short-duration alternations in intravascular volume. SVV could be used as a predictive parameter to evaluate this change.