中华麻醉学杂志
中華痳醉學雜誌
중화마취학잡지
CHINESE JOURNAL OF ANESTHESIOLOGY
2012年
11期
1374-1375
,共2页
王合梅%李超%雍芳芳%贾慧群
王閤梅%李超%雍芳芳%賈慧群
왕합매%리초%옹방방%가혜군
每搏输出量%血管容量%呼吸,人工
每搏輸齣量%血管容量%呼吸,人工
매박수출량%혈관용량%호흡,인공
Stroke volume%Vascular capacitance%Respiration,artifical
目的 探讨每搏量变异度(Svv)与单肺通气患者血容量变化的相关性.方法 择期拟行食管癌切除术患者40例,男性,年龄50～ 60岁,体重指数20 ～ 25 kg/m2,ASA分级Ⅱ级.麻醉诱导后经口明视插入F39右侧双腔支气管导管,经两肺听诊和纤维支气管镜定位后,连接麻醉机行单肺通气,设定潮气量8 ml/kg、呼吸频率15次/min、吸呼比1∶2.单肺通气30 min时静脉输注6％羟乙基淀粉130/0.4,速率为0.67 ml· kg-1·min-1,分别在输注前、输注羟乙基淀粉剂量达2、4、6、8、10、12 ml/kg时采用FloTrac/Vigileo心输出量监测系统记录SVV、CO、SV、CI.SVV、CO、SV、CI与羟乙基淀粉输注量行Spearnan等级相关分析.结果 SVV与单肺通气患者血容量变化呈负相关,CI、CO、SV与单肺通气患者血容量变化呈正相关(P＜0.05),相关系数(r)分别为rSVV:-0.249,r Co:0.570,rSV:0.552,rCI∶0.550.结论 SVV与单肺通气患者血容量变化相关性差,不能准确反映容量的变化.
目的 探討每搏量變異度(Svv)與單肺通氣患者血容量變化的相關性.方法 擇期擬行食管癌切除術患者40例,男性,年齡50～ 60歲,體重指數20 ～ 25 kg/m2,ASA分級Ⅱ級.痳醉誘導後經口明視插入F39右側雙腔支氣管導管,經兩肺聽診和纖維支氣管鏡定位後,連接痳醉機行單肺通氣,設定潮氣量8 ml/kg、呼吸頻率15次/min、吸呼比1∶2.單肺通氣30 min時靜脈輸註6％羥乙基澱粉130/0.4,速率為0.67 ml· kg-1·min-1,分彆在輸註前、輸註羥乙基澱粉劑量達2、4、6、8、10、12 ml/kg時採用FloTrac/Vigileo心輸齣量鑑測繫統記錄SVV、CO、SV、CI.SVV、CO、SV、CI與羥乙基澱粉輸註量行Spearnan等級相關分析.結果 SVV與單肺通氣患者血容量變化呈負相關,CI、CO、SV與單肺通氣患者血容量變化呈正相關(P＜0.05),相關繫數(r)分彆為rSVV:-0.249,r Co:0.570,rSV:0.552,rCI∶0.550.結論 SVV與單肺通氣患者血容量變化相關性差,不能準確反映容量的變化.
목적 탐토매박량변이도(Svv)여단폐통기환자혈용량변화적상관성.방법 택기의행식관암절제술환자40례,남성,년령50～ 60세,체중지수20 ～ 25 kg/m2,ASA분급Ⅱ급.마취유도후경구명시삽입F39우측쌍강지기관도관,경량폐은진화섬유지기관경정위후,련접마취궤행단폐통기,설정조기량8 ml/kg、호흡빈솔15차/min、흡호비1∶2.단폐통기30 min시정맥수주6％간을기정분130/0.4,속솔위0.67 ml· kg-1·min-1,분별재수주전、수주간을기정분제량체2、4、6、8、10、12 ml/kg시채용FloTrac/Vigileo심수출량감측계통기록SVV、CO、SV、CI.SVV、CO、SV、CI여간을기정분수주량행Spearnan등급상관분석.결과 SVV여단폐통기환자혈용량변화정부상관,CI、CO、SV여단폐통기환자혈용량변화정정상관(P＜0.05),상관계수(r)분별위rSVV:-0.249,r Co:0.570,rSV:0.552,rCI∶0.550.결론 SVV여단폐통기환자혈용량변화상관성차,불능준학반영용량적변화.
Objective To evaluate the correlation between stroke volume variation (SVV) and blood volume during one-lung ventilation (OLV).Methods Forty ASA Ⅱ male patients,aged 50-60 yr,with body mass index 20-25 kg/m2,scheduled for elective resection of esophageal cancer,were studied.Anesthesia was induced with fentanyl 4 μg/kg,propofol 2 mg/kg,and rocuronium 0.6 mg/kg.Double-lumen tube was inserted.Correct position was verified by fiberoptic bronchoscopy.The patients were mechanically ventilated (VT 8 ml/kg,RR 15 bpm,Ⅰ ∶ E 1 ∶ 2).6％ hydroxyethyl statch (HES) 130/0.4 was infused intravenously at a rate of 0.67 ml· kg-1 · min-1 starting from 30 min of OLV.SVV,cardiac output (CO),SV and cardiac index (CI) were monitored and recorded using the FloTrac/Vigileo (Edwards Lifesciences,USA) system before HES was infused and when the dose of HES reached 2,4,6,8,10 and 12 ml/kg.Spearman rank sum correlation coefficient was used to analyze the data.Results SVV was negatively correlated with the blood volume during OLV and the correlation coefficient was rSVV =-0.249.CI,CO and SV were positively correlated with the blood volume during OLV and the correlation coefficients were rCO =0.570,rSV =0.552 and rCI =0.550,respectively.Conclusion SVV is poorly correlated with the blood volume during OLV and can not reflect the blood volume accurately.
