本文關(guān)鍵詞：目標(biāo)導(dǎo)向液體療法對(duì)胃腸道手術(shù)患者心臟功能的影響　出處：《華北理工大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 目標(biāo)導(dǎo)向液體療法 胃腸道手術(shù) 心臟功能 心房利鈉肽(ANP) 心肌肌鈣蛋白I(cTnI)

【摘要】：目的觀察目標(biāo)導(dǎo)向液體療法對(duì)胃腸道手術(shù)患者圍術(shù)期心臟功能的影響。方法選取60例擇期行胃腸道手術(shù)的患者,美國(guó)麻醉醫(yī)師學(xué)會(huì)(ASA)分級(jí)Ⅱ-Ⅲ級(jí),將其隨機(jī)分成兩組:實(shí)驗(yàn)組(A組)30例,對(duì)照組(B組)30例,實(shí)驗(yàn)組(A組)根據(jù)每搏量變異度(stroke volume variation,SVV),心臟指數(shù)(cardiac index,CI),每搏輸出量指數(shù)(stroke volume index,SVI)進(jìn)行目標(biāo)導(dǎo)向液體治療。對(duì)照組(B組)根據(jù)中心靜脈壓(CVP)及平均動(dòng)脈壓(MAP)進(jìn)行常規(guī)液體輸注。所有患者入室后連續(xù)監(jiān)測(cè)心電圖(ECG),心率(HR),平均動(dòng)脈壓(MAP),中心靜脈壓(CVP),脈搏血氧飽和度(Sp O2),心輸出量(cardiac output,CO)。記錄手術(shù)前(即麻醉前T1)、手術(shù)開始(T2)、手術(shù)1h(T3)和手術(shù)結(jié)束(T4)4個(gè)時(shí)間點(diǎn)的心臟指數(shù)(cardiac index,CI),動(dòng)脈血?dú)?同時(shí)對(duì)各時(shí)間點(diǎn)的心房利鈉肽(atrial natriuretic peptide,ANP)及心肌肌鈣蛋白I(cardiac troponin I,cTnI)的表達(dá)進(jìn)行測(cè)定。結(jié)果與B組比較,A組晶體液輸液量減少【(966±222)vs(1356±244)ml,P㩳0.05】;但膠體液輸入量增多【(1272±189)vs(983±202)ml,P㩳0.05】,尿量增多【(428±54)vs(359±66)ml,P㩳0.05】。A組較B組術(shù)中血流動(dòng)力學(xué)更加穩(wěn)定,A組T2~T4時(shí)的MAP與CVP均高于B組(P㩳0.05),A組T2~T4時(shí)的CI、SVI、CO均高于B組(P㩳0.05),T2-T4時(shí)測(cè)得的ANP及cTnI數(shù)值實(shí)驗(yàn)組(A組)均低于對(duì)照組(B組)(P㩳0.05)。結(jié)論目標(biāo)導(dǎo)向液體療法能夠維持血流動(dòng)力學(xué)的穩(wěn)定,減少圍術(shù)期心肌的損害,保護(hù)患者的心臟功能。
[Abstract]:Objective To observe the effect of targeted liquid therapy on cardiac function during perioperative period in patients with gastrointestinal surgery . Methods 60 patients with gastrointestinal surgery were randomly divided into two groups : experimental group ( group A ) and control group ( group B ) . The control group ( group A ) was randomly divided into two groups : experimental group ( group A ) , heart index ( CI ) and stroke volume index ( SVI ) . All patients were continuously monitored for electrocardiogram ( ECG ) , heart rate ( HR ) , mean arterial pressure ( MAP ) , central venous pressure ( CVP ) , pulse blood oxygen saturation ( Sp O2 ) and cardiac output ( CO ) . The cardiac index ( CI ) , arterial blood gas , atrial natriuretic peptide ( ANP ) and cardiac troponin I ( cardiac troponin I , cardiac troponin I ) were measured before and after operation ( i.e . , T1 before anesthesia ) , beginning of operation ( T2 ) , operation 1h ( T3 ) and end of operation ( T4 ) . Results Compared with group B , the amount of infusion of atrial natriuretic peptide ( ANP ) and cardiac troponin I ( cardiac troponin I ) in group A were significantly decreased ( 966 鹵 222 ) vs ( 1356 鹵 244 ) ml , P ? 0.05 ) ; however , the volume of colloid fluid increased significantly ( 72 鹵 189 ) vs ( 3.98 鹵 202 ) ml , P ? 0.05 ) , and the urinary volume increased ( 428 鹵 54 ) vs ( 359 鹵 66 ) ml , P ? 0.05 ) . In group A , MAP and CVP were more stable in group A than in group B ( P ? 0.05 ) , and the values of CI , SVI and CO in group A were higher than those in group B ( P ? 0.05 ) . Conclusion The target - guided liquid therapy can maintain the stability of hemodynamics , reduce myocardial damage during perioperative period , and protect the heart function of patients .

【學(xué)位授予單位】：華北理工大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R614
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本文編號(hào)：1391737