PICCO监测心率变异性及心输出量与Narcotrend麻醉深度监测对比研究

摘要

目的 探讨PICCO监测心率变异性及心输出量(CO)与Narcotrend监测麻醉深度相关性.方法 60例食道癌根治术患者采用PICCO监测心电指标,Narcotrend监测麻醉深度,记录麻醉诱导前(T1)、插管定位成功后(T2)、气管插管即刻(T3)、肺萎陷30 min(T4)、双肺通气后(T5)、术后10 min(T6)的NT值、NT分级、心脏指数(CI)、心率(HR)、平均动脉压(MAP)、心输出量(CO),Poincare散点图分析心率短轴(SD1)及长轴(SD2)变化.结果 监测期间(T1~T6)CI、CO、SD1与NT呈低度线性相关,P<0.001;SD2与NT呈显著性相关,P < 0.001;术中(T2~T5)术中CI、CO、SD1、SD2与NT呈低度线性相关,P <0.001.结论 全麻手术中监测心率变异性(SD1、SD2)及心输出量(CO)与麻醉深度NT值呈相关性,协同监测有助于提升麻醉安全性.%Objective To explore the correlation of heart rate variability(HRV)and cardiac output by PICCO with anesthetic depth by Narcotrend monitoring. Methods 60 patients with radical resection of esophageal cancer were enrolled in the study. PICCO was used to monitor ECG and Narcotrend was use to monitor anesthetic depth.The NT value,NT grade,Cardiac index(CI),heart rate(HR),mean arterial pressure(MAP),cardiac output(CO),Poincare scattergram Scatter plot minor axis(SD1)and scatter plot major axis(SD2)were recorded and measured at the time points of pre-anesthesia induction(T1),post-successful intubation(T2),tracheal intu-bation moment(T3),lung collapse for 30 min(T4),post-lung ventilation(T5)and 10min after operation(T6). Results Person's correlation analysis showed that during the monitoring period(T1-T6),CI,CO,SD1 and NT showed a low linear correlation(P < 0.001);SD2 was significantly correlated with NT(P <0.001). There was a low linear correlation between CI,CO,SD1,SD2 and NT at the operation time(T2-T5). Conclusion During general anesthesia,heart rate variability(SD1,SD2)and cardiac output(CO)are correlated with the NT value of anesthesia depth.Collaborative monitoring could help to enhance the safety of anesthesia.