天津医药

天津医药 ›› 2017, Vol. 45 ›› Issue (3): 294-296.doi: 10.11958/20160785

• 临床研究 • 上一篇    下一篇

基于 FloTrac/Vigileo 监测不同 PEEP 值对患者心指数、每搏变异度及氧输送指数的影响

孙振涛 1， 王宁 1， 孙雪青 2， 向导 1， 曹亚楠 1， 韩雪萍 1， 任苏恩 3   

  1. 1 郑州大学第一附属医院麻醉科 （邮编 450000）； 2 大同市第三人民医院麻醉科； 3 河南省胸科医院麻醉科
  • 收稿日期:2016-08-05 修回日期:2017-02-09 出版日期:2017-03-15 发布日期:2017-03-21
  • 基金资助:
    河南省医学科技攻关项目 （201503037）； 河南省重点科技攻关项目 （132102310103）； 河南省教育厅科技攻关项目 （13B320389）

The effects of different values of PEEP on heart index, stroke volume variation and oxygen transport index in patients monitored by FloTrac/Vigileo system

SUN Zhen-tao1, WANG Ning1, SUN Xue-qing2, XIANG Dao1, CAO Ya-nan1, HAN Xue-ping1, REN Su-en3   

  1. 1 Department of Anesthesiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China; 2 Department of Anesthesiology, the Third People’ s Hospital of Datong; 3 Department of Anesthesiology, Henan Provincial Chest Hospital
  • Received:2016-08-05 Revised:2017-02-09 Published:2017-03-15 Online:2017-03-21

PDF (PC)

3741

摘要： 摘要： 目的 探讨 FloTrac/Vigileo 监测下不同呼气末正压通气（PEEP）值对患者心指数（CI）、 每搏变异度（SVV）及氧输送指数 （DO2I） 的影响， 为患者血流动力学管理和改善氧合治疗提供参考依据。方法 择期行电视辅助胸腔镜食管癌根治术患者 60 例， 使用 FloTrac/Vigileo 系统观察患者 CI、 SVV 及 DO2I 的变化， 记录麻醉诱导后改左侧卧位（T0）、 开 CO2气胸+0 PEEP 5 min（T1）后、 开 CO2气胸+5 PEEP 5 min（T2）后、 开 CO2气胸+10 PEEP 5 min 后（T3）、 开CO2气胸+15 PEEP 5 min 后（T4）患者的 CI、 SVV 及 DO2I。结果 与 T0 时点比较， T1、 T2、 T3 和 T4 时点患者 CI 下降， SVV 升高（P＜0.05）； 与 T1 时点比较， T4 时点患者 CI 下降， SVV 升高， T2、 T3 时点 DO2I 升高（P＜0.05）。结论术中采用呼气末正压通气会对患者的 CI 及 SVV 造成一定的影响， 采取 5~10 PEEP 值可显著改善氧合并且对 CI 和SVV 影响较小， 可以适当地应用于临床中。

关键词: 正压呼吸, FloTrac/Vigileo 系统, 心指数, 每搏变异度, 呼气末正压通气

Abstract: Abstract: Objective To investigate the effects of different values of PEEP on cardiac index (CI), stroke volume nvariation (SVV) and oxygen transport index (DO2I) in patients monitored by FloTrac/Vigileo system, and to provide some references for the hemodynamic management and improvement of oxygenation for patients. Methods Sixty patients scheduled for elective television (TV) auxiliary thoracoscope radical operation for esophageal cancer were included in this study. Data of CI, SVV and DO2I were observed by the FloTrac/Vigileo system. Changes of CI, SVV and DO2I were recorded after anesthesia induction and turn left side (T0), artificial pneumothorax with 0 PEEP after 5 minutes (T1), artificial pneumothorax with 5 PEEP after 5 minutes (T2), artificial pneumothorax with 10 PEEP after 5 minutes (T3), and artificial pneumothorax with 15 PEEP after 5 minutes (T4). Results Compared with T0, CI decreased and SVV increased significantly at T1, T2, T3 and T4（P＜0.05). Compared with T1, CI decreased and SVV increased at T4. DO2I increased at T2 and T3 compared with that of T1（P＜0.05). Conclusion PEEP may have a certain influence on CI and SVV in the process of operation. The values of 5- 10 PEEP can significantly improve oxygenation and have a less influence on hemodynamics, which can be appropriately used in clinical care.

Key words: positive-pressure respiration, FloTrac/Vigileo system, cardiac index, stroke volume variation, PEEP