脑肿瘤手术围手术期灌注变异指数和中心静脉压的相关性研究被引量：3

Correlation of pleth variability index with central venous pressure

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摘要目的观察灌注变异指数（PVI）和中心静脉压（CVP）持续监测用于脑肿瘤手术患者时的变化，探讨PVI和CVP的相关性。方法42例选择ASA分级为Ⅱ-Ⅲ级择期行脑肿瘤切除术患者，入室后持续监测PVI，局部麻醉下行中心静脉穿刺监测CVP。麻醉方式采用全凭静脉麻醉。记录入室时、手术开始时、手术开始后30min、60min、90min和120min时间点的CVP和PVI。结果PVI和CVP在自主呼吸下（入室时）的相关系数r=0．201，机械通气下的相关系数r=0．237。结论PVI和CVP的相关性差，联合指导容量管理的应用价值可能还需要进一步的评估。 Objective To observe the changes of pleth variability index （PVI） and central venous pressure （CVP） in patients undergo- ing resection operation of brain neoplasms,and the correlation of PVI with CVP was investigated. Methods Forty-two patients （ASA Ⅱ-Ⅲ grade） undergoing elective resection operation of brain neoplasms were included in the study. PVI was monitored continously with Masio Radical-7 pulse oximeter after patient entering operative room. CVP was monitored after central venous catheterization placed with regional an- esthesia. Total intravenous anesthesia was chosen. CVP and PVI were recorded at the time of entering operative room, operation began, and 30 minutes,60 minutes,90 minutes, 120 minutes after the beginning of operation. Results The correlation coefficient of PVI with CVP was 0. 201 under spontaneously breathing （ at patient entering operative room before anesthesia） and was 0. 237 under mechanical ventilation. Conclusion Correlation of PVI and CVP is lower. The value of PVI might need further research for guiding volume management.

作者王娟丽罗中兵杨俊哲

机构地区武汉市三医院光谷院区广州军区武汉总医院麻醉科

出处《局解手术学杂志》 2015年第6期643-646,共4页 Journal of Regional Anatomy and Operative Surgery

关键词中心静脉压灌注变异指数容量脑肿瘤手术麻醉 central venous pressure pleth variability index volume brain neoplasms surgery anesthesia

分类号 R614 [医药卫生—麻醉学]

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1Cannesson M. Arterial pressure variation and goal-direccted fluid thera- py[ J:. J Cardiothor Vasc Anesth,2010,24 (3) :d87 - 497.
2Osman D, Ridel C, Ray P, et al. Cardiac filling pressures are not appro- priate to predict hemodynamic response to volume challenge [ J ]. Crit Care Med,2007,35 ( 1 ) :64 - 68.
3黄巍,王文浩,郁毅刚,罗飞,林俊明,张源,李君,张明升,胡连水.重型颅脑创伤并发大面积脑梗死的成因分析[J].局解手术学杂志,2012,21(6):607-609. 被引量：16
4Kobayashi M, Koh M, Irinoda T, et al. Stroke volume variation as a pre- dictor of intravaseular volume depression and possible hypotension dur- ing the early postoperative period after esophageetomy [ J 1. Ann Surg Onco1,2009,16 (5) : 1371 - 1377.
5Cannesson M, Musard H, Desebbe O, et al. The ability of stroke volume variations obtained with Vigileo/FloTrae system to monitor fluid respon- siveness in mechanically ventilated patients [ J 1. Anesth Analg, 2009, 108(2) :513 -517.
6Kramer A, Zygun D, Hawes H, et al. Pulse pressure variation predicts fluid responsiveness following coronary artery bypass surgery[ J]. Chest, 2004,126(5) :1563 - 1568.
7Cavallaro F, Sandroni C, Antonelli M, et al. Functional hemodynamic monitoring and dynamic indices of fluid responsiveness [ J 1. Minerva anestesiol,2008,74 (4) : 123 - 135.
8尹健一,李幼生,黎介寿.脉氧容积变异指数预测扩容反应的基本原理及临床应用[J].中华危重病急救医学,2013,25(5):314-318. 被引量：5
9Yin JY, Ho KM. Use of plethysmographic variability index derived from the Massimo pulse oximeter to predict fluid or preload responsiveness:a systematic review and meta-analysis E J 1. Anaesthesia, 2012,67 ( 7 ) : 777 - 783.
10Hood JA, Wilson RJ. Pleth variability index to predict fluid responsive- ness in colorectal surgery [ J ]. Anesth Analg,2011,113 (5) : 1058 - 1063.

二级参考文献46

1Tawil I ,Stein DM, Mirvis SE,el al. Posttramnatic cerebral infartqion : inci- dence, outcome, and risk factors [ J ]. J Trauma,2008,64 (4) :849 - 853.
2Latronico N,Marino R. Psttrauma/ic cerebral infarction (PTCI) in pa- lients wilh severe head trauma[ J 1. J Trauma,2009,66(6 ) : 1745 - 1746.
3l)e Caro R, Munari PF,Parenti A. Middle cerebral artetthrombosis following blunt head trauma[ J ]. Clin Neuropathol, 1998,17 ( 1 ) : 1 - 5.
4Metz C,Taeger K. Head-brain injury and cerebral hypoxia. Diagnosis mo- nitoring therapy [ J ]. Ansesthesist, 2000,49 ( 4 ) : 332 - 339.
5Yin JY,Ho KM. Use of plethysmographic variability index derived from the Massimo (R) pulse oximeter to predict fluid or preload responsiveness:a systematic review and meta-analysis[J].Anaesthesia,2012.777-783.
6Dellinger RP,Levy MM,Carlet JM. Surviving Sepsis Campaign:international guidelines for management of severe sepsis and septic shock:2008[J].Critical Care Medicine,2008.296-327.
7Hamilton MA,Cecconi M,Rhodes A. A systematic review and meta-analysis on the use of preemptive hemodynamic intervention to improve postoperative outcomes in moderate and high-risk sorgical patients[J].Anesthesia and Analgesia,2011.1392-1402.
8Giglio MT,Marucci M,Testini M. Goal-directed haemodynamic therapy and gastrointestinal complications in major surgery:a meta-analysis of randomized controlled trials[J].British Journal of Anaesthesia,2009.637-646.
9Michard F,Teboul JL. Predicting fluid responsiveness in ICU patients:a critical analysis of the evidence[J].Chest,2002.2000-2008.
10Marik PE,Baram M,Vahid B. Does central venous pressure predict fluid responsiveness? A systematic review of the literature and the tale of seven mares[J].Chest,2008,(1):172-178.doi:10.1378/chest.07-2331.