国际麻醉学与复苏杂志
國際痳醉學與複囌雜誌
국제마취학여복소잡지
INTERNATIONAL JOURNAL OF ANESTHESIOLOGY AND RESUSCITATION
2013年
11期
974-976,985
,共4页
张建海%徐子锋%郑吉建%王莹恬
張建海%徐子鋒%鄭吉建%王瑩恬
장건해%서자봉%정길건%왕형념
灌注指数%灌注指数变异度%伤害性刺激
灌註指數%灌註指數變異度%傷害性刺激
관주지수%관주지수변이도%상해성자격
Perfusion index%Pleth variability index%Noxious stimulus
目的 评价灌注指数变异度(pleth variability index,PVI)对伤害性刺激反应的监测作用. 方法 择期行胃部手术患者,按随机数字表法随机分为两组:单纯气管插管全身麻醉(GA)组和全身麻醉联合硬膜外阻滞(GE)组,每组30例.记录手术切皮前后的心率(heart rate,HR)、平均桡动脉压(mean radial artery blood pressure,MBP)、灌注指数(perfusion index,PI)和PVI. 结果 两组手术切皮前后,HR和MBP变化差异无统计学意义(P＞0.05).GA组PI在手术切皮后1 min和5 min均显著下降,切皮前为(2.7±0.6)％,手术切皮后1 min和5 min分别降低为(0.77±0.28)％和(0.7±0.4)％.PVI均大幅增加(P＜0.05),切皮前为(10.8±2.6)％,手术切皮后1 min和5 min分别(23.7±3.6)％和(26.6±4.1)％;GE组切皮前后PI和PVI差异无统计学意义(P＞0.05).两组组间比较,手术切皮前各项指标差异无统计学意义.手术切皮后1 min和5min,HR和MBP差异无统计学意义(P＞0.05),PI和PVI差异有统计学意义(P＜0.05).比较切皮前后PI和PVI呈显著负相关. 结论 PVI是一种无创监测手术伤害性刺激反应的有效指标.
目的 評價灌註指數變異度(pleth variability index,PVI)對傷害性刺激反應的鑑測作用. 方法 擇期行胃部手術患者,按隨機數字錶法隨機分為兩組:單純氣管插管全身痳醉(GA)組和全身痳醉聯閤硬膜外阻滯(GE)組,每組30例.記錄手術切皮前後的心率(heart rate,HR)、平均橈動脈壓(mean radial artery blood pressure,MBP)、灌註指數(perfusion index,PI)和PVI. 結果 兩組手術切皮前後,HR和MBP變化差異無統計學意義(P＞0.05).GA組PI在手術切皮後1 min和5 min均顯著下降,切皮前為(2.7±0.6)％,手術切皮後1 min和5 min分彆降低為(0.77±0.28)％和(0.7±0.4)％.PVI均大幅增加(P＜0.05),切皮前為(10.8±2.6)％,手術切皮後1 min和5 min分彆(23.7±3.6)％和(26.6±4.1)％;GE組切皮前後PI和PVI差異無統計學意義(P＞0.05).兩組組間比較,手術切皮前各項指標差異無統計學意義.手術切皮後1 min和5min,HR和MBP差異無統計學意義(P＞0.05),PI和PVI差異有統計學意義(P＜0.05).比較切皮前後PI和PVI呈顯著負相關. 結論 PVI是一種無創鑑測手術傷害性刺激反應的有效指標.
목적 평개관주지수변이도(pleth variability index,PVI)대상해성자격반응적감측작용. 방법 택기행위부수술환자,안수궤수자표법수궤분위량조:단순기관삽관전신마취(GA)조화전신마취연합경막외조체(GE)조,매조30례.기록수술절피전후적심솔(heart rate,HR)、평균뇨동맥압(mean radial artery blood pressure,MBP)、관주지수(perfusion index,PI)화PVI. 결과 량조수술절피전후,HR화MBP변화차이무통계학의의(P＞0.05).GA조PI재수술절피후1 min화5 min균현저하강,절피전위(2.7±0.6)％,수술절피후1 min화5 min분별강저위(0.77±0.28)％화(0.7±0.4)％.PVI균대폭증가(P＜0.05),절피전위(10.8±2.6)％,수술절피후1 min화5 min분별(23.7±3.6)％화(26.6±4.1)％;GE조절피전후PI화PVI차이무통계학의의(P＞0.05).량조조간비교,수술절피전각항지표차이무통계학의의.수술절피후1 min화5min,HR화MBP차이무통계학의의(P＞0.05),PI화PVI차이유통계학의의(P＜0.05).비교절피전후PI화PVI정현저부상관. 결론 PVI시일충무창감측수술상해성자격반응적유효지표.
Objective To investigate whether the pleth variability index (PVI),a noninvasive and continuous tool,was to predict the nociceptive stimulus.Methods Patients with ASA status Ⅰ-Ⅱ undergoing gastric operation were randomly divided into two groups:tracheal intubation general anesthesia (group GA) and combined general-epidural anesthesia (group GE) in 30 cases.Heart rate(HR),mean radial artery blood pressure(MBP),perfusion index(PI),PVI were recorded before and after the skin incision.Results The skin incision did not affect the HR and MBP in two groups.The PI in group GA decreased significantly from(2.7 ±0.6)％to (0.77±0.28)％ and (0.7±0.4)％ at 1 min and 5 min after the skin incision.The PVI increased significantly form (10.8±2.6)％ to (23.7 ±3.6)％ and (26.6 ±4.1)％ at 1 min and 5 min after the skin incision.Both the PVI and the PI had no significant change in group GE after the skin incision.There were significant differences of PI and PVI between two groups after the skin incision.A significant negative correlation was observed between the changes in PI and PVI before and after the skin incision.Conclusions The PVI is a noninvasive and effective tool to monitor the patient's noxious stimulation.
