胶体液预充对冠脉搭桥术患者血流动力学的影响

摘要

目的 观察全麻诱导期胶体液预充对冠脉搭桥术患者血流动力学的影响.方法 择期行冠脉搭桥术患者35例,随机分为两组.容量预充组(V组,n=18)从诱导开始10 min内匀速输注6%羟乙基淀粉5 ml/kg,对照组(C组,n=17)从诱导开始10 min内匀速输注6%羟乙基淀粉0.5ml/kg.结果 V组去氧肾上腺素、艾司洛尔使用明显低于C组(P< 0.01).麻醉诱导稳定后C组MAP、CVP低于V组(P<0.05);但在气管内插管、切皮及锯胸骨时HR、MPAP、PCWP高于V组(P<0.05).结论 全麻诱导期胶体液预充有利于维持冠脉搭桥术患者血流动力学的稳定.%Objective To observe the hemodynamic response to volume packing of colloid in patients of coronary artery bypass grafts. Methods Thirty-five patients undergoing elective coronary artery bypass grafts were randomly allocated to two groups: (group C, n= 17)and (group V, n= 18).6％ hydroxyethyl starch (HES) 0. 5 ml/kg was infused in 10 min as soon as induction of anesthesia was started in group C. While in group V, HES 5 ml/kg was infused at the first 10 min of anesthesia induction. Results The dosage of vasoactive drugs was significantly decreased in group V than that in group C(P＜0. 01). In group V, the MAP and CVP was significantly lower after induction than that in group V(P＜0. 05); but the HR, MPAP and PCWP were significantly higher at the times of intubation, incision and sewing sternum than in group V(P＜0. 05 ). Conclusion The effect of volumn packing of colloid is beneficial to maintain hemodynamic stability during induction of general anesthesia.