FloTrac/Vigileo系统用于单肺通气血流动力学的监测

摘要

Objective To explore the feasibility of FloTrac/Vigileo System in hemodynamic monitoring during the surgery of single-lung ventilation patients.Methods Twenty-five patients with thoracoscopic lobectomy under general anesthesia,aged 35-65 years,ASA physical status Ⅰ or Ⅱ, preoperative showed no application taboo of FloTrac/Vigileo system or transesophageal echocardio-graphy (TEE).The radial artery puncture catheter was inserted after getting into the operating room, then connect the FloTrac/Vigileo system,after that the TEE was inserted following the induction of general anesthesia.Using the FloTrac/Vigileo system to record the stroke volume (SVF),cardiac output (COF),stroke volume variation (SVV),at the moment of after turning over (T0),opening chest and single-lung ventilation(T1),single-lung ventilation for 15 minutes (T2),single-lung venti-lation for 30 minutes (T3),single-lung ventilation for 45 minutes (T4)single-lung ventilation for 60 minutes (T5).Using TEE to monitor the index and record the the stroke volume (SVT)cardiac out-put(COT)and inferior vena cava collapse index(cIVC)of the same patient at same time as Group F. Results There was no statistically significant different between SVFand SVTat T0-T5in both groups,Overall correlation analysis,r=0.84,P<0.01.There is no statistically significant different between COFand COTat T0-T5in both groups,Overall correlation analysis,r=0.92,P<0.01. Correlation analysis of SVV of group F and cIVC of group T,the results were positively correlate,r=0.80,P<0.01.Conclusion FloTrac/Vigileo system can be used as a monitoring method for mo-nitoring hemodynamics in thoracic surgery.%目的 探讨 FloTrac/Vigileo系统在单肺通气患者术中血流动力学监测的可行性.方法 选取全麻胸腔镜下肺叶切除术患者25例,年龄35~65岁,ASA Ⅰ或Ⅱ级,术前无FloTrac/Vig-ileo系统及经食管超声心动图(TEE)应用禁忌证.入室行桡动脉穿刺置管,连接 FloTrac/Vigileo 系统,并于全麻诱导后置入TEE探头.分别同时采用 FloTrac/Vigileo系统与TEE监测并记录侧卧翻身后(开胸前,T0)、开胸单肺通气即刻(T1)、单肺通气15 min(T2)、单肺通气30 min(T3)、单肺通气45 min(T4)、单肺通气60 min(T5)的 SV、CO、SVV(FloTrac/Vigileo 系统)或 cIVC(TEE监测).其中由 FloTrac/Vigileo系统所测的 SV 和 CO 等记作 SVF、COF;由 TEE 所测的记作 SVT、COT.结果 T0~T5时 SVF和 SVT差异无统计学意义;整体相关性分析,相关系数r=0.84,P<0.01.T0~T5时COF和COT差异无统计学意义;整体相关性分析,相关系数r=0.92,P<0.01.SVV和的cIVC整体相关性分析,结果呈正相关,相关系数r=0.80,P<0.01.结论 FloTrac/Vigileo 系统可在胸科手术中作为术中血流动力学的监测方法.