【摘要】：一、目的： 研究PiCCO（脈搏指示連續(xù)心輸出量）監(jiān)測(cè)在PKRP（經(jīng)尿道等離子前列腺電切術(shù)）患者容量監(jiān)測(cè)中的臨床意義，從而達(dá)到提高患者圍術(shù)期安全，促進(jìn)患者順利康復(fù)的目的。 二、方法： 選擇ASAI-II級(jí)20例前列腺增生癥行PKRP手術(shù)患者，分別在手術(shù)前（T0)、麻醉誘導(dǎo)后5分鐘（T1)、灌注5000ml(T2)時(shí)、灌注10000ml(T3)時(shí)、灌注15000ml(T4)時(shí)、灌注20000ml(T5)時(shí)，，通過PiCCO監(jiān)測(cè)CI（心指數(shù)）、GEDI(全心舒張末期容積指數(shù))、ITBI(胸腔內(nèi)血容量指數(shù))、EWLI（血管外肺水指數(shù)）；通過多功能監(jiān)護(hù)儀監(jiān)測(cè)HR（心率）、MAP（平均動(dòng)脈壓）、SPO2（氧飽和度）、CVP（中心靜脈壓）、BIS(腦電雙頻指數(shù))。 三、結(jié)果： 與手術(shù)前相比，患者心輸出量、全心舒張末期血容積、胸腔內(nèi)血容量在麻醉誘導(dǎo)后有顯著下降（P0.05），隨后逐漸回升。在手術(shù)過程中,生理鹽水沖洗量20000ml，各時(shí)間點(diǎn)心輸出量、全心舒張末期血容量、胸腔內(nèi)血容量與手術(shù)初期相比變化無顯著差異（P0.05）。 四、結(jié)論： （1）在PKRP手術(shù)中，PiCCO監(jiān)測(cè)中CI、GEDI、ITBI等指標(biāo)能靈敏、準(zhǔn)確地反映患者血流動(dòng)力學(xué)變化，對(duì)評(píng)估患者容量狀態(tài)有指導(dǎo)意義。 （2）PKRP手術(shù)采用0.9%生理鹽水做為灌注液，當(dāng)沖洗量小于20000ml時(shí)，對(duì)本研究中的患者血流動(dòng)力學(xué)影響較小。
[Abstract]:Objective: to study the clinical significance of PiCCO (pulse indicating continuous cardiac output) monitoring in patients with PKRP (transurethral plasma prostatectomy), so as to improve the perioperative safety of patients. The purpose of promoting the smooth recovery of patients. Methods: twenty patients with ASAI-II grade benign prostatic hyperplasia underwent PKRP operation. Before operation (T0), 5 minutes after anesthesia induction (T1), 5 minutes after anesthesia induction (T1), 5000ml (T2), 10000ml (T3) and 15000ml (T4) were perfused. When 20000ml (T5) was infused, CI was monitored by PiCCO (), GEDI (total diastolic volume index (), ITBI (), intrathoracic blood volume index (), EWLI (), extravascular pulmonary fluid index (), EWLI (). HR (heart rate), MAP (mean arterial pressure) and SPO2 (oxygen saturation), CVP (central venous pressure), BIS (bispectral index) were monitored by multifunctional monitor. Results: compared with before operation, the cardiac output, end-diastolic blood volume and intrathoracic blood volume of patients decreased significantly after anesthesia induction (P0.05), and then increased gradually. During the operation, there was no significant difference in the volume of saline irrigation, the output of dim sum at each time, the end-diastolic blood volume of the whole heart and the blood volume in the thoracic cavity (P0.05). Conclusion: (1) in PKRP operation, the indexes such as CI,GEDI,ITBI in PiCCO monitoring can reflect the hemodynamic changes of the patients accurately and sensitively, and have a guiding significance in evaluating the volume status of the patients. (2) 0.9% normal saline was used as perfusion fluid in PKRP operation. When the amount of irrigation was less than 20000ml, the hemodynamics of the patients in this study was less than that of normal saline.
【學(xué)位授予單位】：蘇州大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R614

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