首页> 中文期刊>中国临床新医学 >冠心病患者麻醉诱导期间应用 FloTrac/Vigileo 系统监测参附注射液对血流动力学的影响

冠心病患者麻醉诱导期间应用 FloTrac/Vigileo 系统监测参附注射液对血流动力学的影响

     

摘要

Objective To observe the effects of Shenfu injection on hemodynamics in patients with heart dis -ease by FloTrac/Vigileo System during induction of general anesthesia .Methods 50 patients with coronary heart dis-ease but without heart operation were randomly divided into Shenfu group and control group , with 25 cases in each group.Shenfu group was intravenously injected with Shenfu injection 1 ml/kg before the induction of anesthesia , and the control group was injected with lactated Ringer′s solution 1 ml/kg in the same way as Shenfu group .Anesthesia induction was performed in both of the groups after 5 min of drug injections .The method of anesthesia induction and maintenance was the same as that in the two groups .Mean arterial pressure(MAP), heart rate(HR), heart output (CO), cardiac index(CI), stroke volume(SV) and stroke volume variation(SVV) were monitored and calculated by FloTrac at T0(baseline level), T1(after injecting Shenfu or lactated Ringer′s solution ), T2(1 min before intuba-tion), T3(tracheal intubation), T4(1 min after tracheal intubation) and T5(5 min after trachea intubation).Results There were no significantly differences between the two groups at T 0, T1(P>0.05);MAP, HR, CO, CI and SV of both groups were significantly decreased at T2 compared with those at T0(P<0.05).CO, CI, SV of Shenfu group were significantly higher than those of the control group ( P<0.05 ); SVV of the control group was significantly in-creased and significantly higher than that of Shenfu group (P<0.05).At T3 and T4, MAP, HR, CO, CI and SV of both groups were increased , with MAP and HR of the control group being increased more than those of Shenfu group (P<0.05);At T5, MAP, HR, CO, CI and SV of Shenfu group turned to the levels at T 0, while those of the con-trol group were lower than the levels at T 0 ( P<0.05 ) .Conclusion Shenfu injection is effective in attenuating the decrease of CO during the induction of anesthesia ,and beneficial to maintaining hemodynamics stability .%目的:观察冠心病患者麻醉诱导期间应用FloTrac/Vigileo系统监测参附注射液对血流动力学的影响。方法选择冠心病患者非心脏全麻手术50例,随机分为参附组和对照组,每组25例。参附组在麻醉诱导前静注参附注射液1 ml/kg,对照组于麻醉诱导前静注乳酸林格氏液1 ml/kg,5 min后麻醉诱导。两组全麻诱导和维持方法相同。应用心电监护仪及FloTrac分别于T0(入室时)、T1(使用参附或乳酸林格氏液后)、T2(气管插管前1 min)、T3(气管插管时)、T4(气管插管后1 min)和T5(气管插管后5 min)监测平均动脉压(MAP)、心率(HR)、心输出量(CO)、心脏指数(CI)、每搏输出量(SV)、每搏量变异度(SVV)。结果T0、T1时两组各指标比较差异无统计学意义( P>0.05)。与T0相比,T2时各组MAP、HR、CO、CI和SV均显著降低( P<0.05),但参附组的CO、CI、SV明显高于对照组( P<0.05);对照组SVV显著升高,并且明显高于参附组( P<0.05)。 T3、T4时MAP、HR、CO、CI和SV均有所上升,MAP、HR上升幅度对照组大于参附组( P<0.05);T5时参附组MAP、HR、CO、CI和SV恢复至T0时,而对照组各指标显著低于T0时( P<0.05)。结论参附注射液可改善麻醉诱导造成的心排出量降低,有效维持冠心病患者麻醉诱导期间血流动力学稳定。

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