本文選題：老年患者　切入點(diǎn)：氣管插管　出處：《南京醫(yī)科大學(xué)學(xué)報(bào)(自然科學(xué)版)》2017年07期

【摘要】：目的:對(duì)需要?dú)夤懿骞艿睦夏昊颊咴诼樽碚T導(dǎo)前按照血壓常規(guī)輸液,或在經(jīng)胸超聲監(jiān)測(cè)下腔靜脈塌陷率(IVC-CI)指導(dǎo)下行液體治療,比較兩組在低血壓、氧代謝障礙發(fā)生率方面的差異。方法:氣管插管機(jī)械通氣的老年患者60例,隨機(jī)分為兩組,每組30例。插管誘導(dǎo)前均記錄心率(HR)、平均動(dòng)脈壓(MAP)、中心靜脈壓(CVP)、氧合指數(shù)(P/F)、中心靜脈氧飽和度(ScvO_2)、中心靜脈-動(dòng)脈二氧化碳分壓差(Pcv-aCO_2)。對(duì)照組在MAP65 mmHg時(shí)給予500 mL平衡鹽溶液15 min內(nèi)快速靜脈滴注;在MAP≥65 mmHg時(shí)不給予液體輸注。實(shí)驗(yàn)組彩超測(cè)量下腔靜脈直徑(dIVC),根據(jù)公式計(jì)算IVC-CI,在IVC-CI≥50%給予500 mL平衡鹽溶液15 min內(nèi)快速靜脈滴注;IVC-CI50%,不給予液體輸注。麻醉誘導(dǎo)后均再次記錄HR、MAP、CVP、P/F、ScvO_2、Pcv-aCO_2。結(jié)果:實(shí)驗(yàn)組患者血壓在誘導(dǎo)前后沒(méi)有明顯變化(P0.05),但是患者的心率降低,CVP、P/F、ScvO_2增高(P0.05),差異均具有統(tǒng)計(jì)學(xué)意義。對(duì)照組患者誘導(dǎo)后血壓降低、P/F增高(P0.05),差異均具有統(tǒng)計(jì)學(xué)意義,HR、CVP、ScvO_2差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。不論是實(shí)驗(yàn)組還是對(duì)照組,Pcv-aCO_2雖然都有下降,但均不具有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:超聲監(jiān)測(cè)下腔靜脈塌陷率評(píng)估容量相對(duì)于傳統(tǒng)的容量評(píng)估方法,具有快速、準(zhǔn)確、不增加患者風(fēng)險(xiǎn)的優(yōu)點(diǎn)。
[Abstract]:Objective: to compare the hypotension between the two groups in elderly patients who need tracheal intubation before anesthesia induction according to routine infusion of blood pressure or under the guidance of IVC-CI under the monitoring of vena cava collapse rate by transthoracic ultrasound.Differences in the incidence of oxygen metabolism disorders.Methods: 60 elderly patients with mechanical ventilation were randomly divided into two groups, 30 cases in each group.Heart rate (HR), mean arterial pressure (map), central venous pressure (CVP), oxygenation index (P / F), central venous oxygen saturation (scvO _ 2), central veno-arterial CO _ 2 partial pressure difference (Pcv-aCO _ 2) were recorded before intubation induction.The control group was given 500ml equilibrium salt solution intravenously for 15 min at MAP65 mmHg, and no infusion of liquid at MAP 鈮，

本文編號(hào)：1701688