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不同补液方案对开胸手术单肺通气患者血管外肺水的影响 被引量:1

Effect of different fluid therapy regiments on extravascular lung water in patients undergoing thoracotomy with one-lung ventilation
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摘要 目的探讨不同补液方案对食管癌根治术患者血管外肺水的影响,寻求合适的晶胶配比方案。方法 45例食管癌根治术患者分为A组(晶体组);B组(晶∶胶=1∶1);C组(晶∶胶=1∶2)。脉搏指示剂连续心排出量(PiCCO)记录术前(T_0)、插管后5min(T_1)、双肺通气15min(T_2)、单肺通气15min(T_3)、肺复张双肺通气15min(T_4)和术毕(T_5)时平均动脉压(MAP)、心指数(CI)、胸内血容量指数(ITBVI)、全心舒张末期容量指数(GEDVI)、血管外肺水指数(EVLWI)及T_0、T_5血乳酸(Lac)。结果 C组T5时CI、ITBVI、GEDVI与T_0比较显著增加,且该时点均显著高于A组(P<0.05)。与T_0比,A组T4、T5时EVLWI显著增加且T_5时显著高于C组(P<0.05)。与T_0比,A组T_5时Lac显著增加(P<0.05)。结论晶体与胶体1∶1补液方案维持食管癌根治患者术中血流动力学平稳,对血管外肺水无影响。 Objective To investigate the effect of different fluid therapy regiments on extravaseular lung water in patients undergoing thoraeotomy,and to explore appropriate ratio of erystalloid-colloid solution. Methods Forty-five patients scheduled for esophagectomy were randomly divided into 3 groups: group A (crystal fluid),group B (crystal : colloid fluid=1:1) and group C (crystal: colloid fluid=1:2). The mean artery pressure (MAP), cardiac index(CI), intrathoracic blood volume index (ITBVI), global end-diastolic volume index (GEDVI) and extravascular lung water index (EVLWI) were recorded with pulse indicator con- tinuous cardiac output (PiCCO) system at the following time points:pre-surgery(T0), 5 min after intubation(T1 ), 15 rain after total lung ventilation(T2 ), 15 min after one-lung ventilation(T3 ), 15 min after pulmonaryre-expansion(T4 ) and the end of operation (T5). The lactate concentration(Lac) was measured at T0 and T5. Results Compared with T0 ,CI,ITBVI and GEDVI were signifi- cantly increased at T5 in the group C and were significantly higher than those of group A at the same time point (P〈0.05). Com- pared with To, EVLWI in Group A at T4 and T5 was significantly increased and was significantly higher than that of group C at T5 (P〈0.05). Compared with T0 ,the lactate concentration of group A was significantly increased at T5 (P〈0. 05). Conclusion Fluid administration of crystal-colloid ratio(1 : 1) not only maintained stable intraoperafive hemodynamics but also did not increase the risk pulmonary edema in patients undergoing esophagectomy.
出处 《重庆医学》 CAS 北大核心 2016年第24期3381-3384,共4页 Chongqing medicine
关键词 食管肿瘤 血管外肺水 单肺通气 胸内血容量指数 esophageal neoplasms extravaseular lung water one-lung ventilation intrathoraeic blood volume index
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  • 1钟建勤,钟志民,高翔.动态监测血乳酸对危重病人在预后中价值[J].实用临床医学(江西),2006,7(1):36-37. 被引量:19
  • 2杨从山,邱海波,刘松桥,杨毅,黄英姿,刘玲.血管外肺水指数对感染性休克患者预后的评价[J].中华内科杂志,2006,45(3):192-195. 被引量:53
  • 3张纳新,秦英智,徐磊,展春,王书鹏.连续血流动力学监测技术在机械通气患者中的应用研究[J].中国危重病急救医学,2006,18(6):359-362. 被引量:35
  • 4Licker M,Fauconnet P,Villiger Y,et al.Acute lung injury and outcomes after thoracic surgery.Curr Opin Anaesthesiol,2009,22(1):61-67.
  • 5van der Linden P.Volume optimization in surgical patients:wet or dry?Acta Anaesthesiol Belg,2007,58(4):245-250.
  • 6Mckevith JM,Pennefather SH.Respiratory complications after oesophageal surgery.Curr Opin Anaesthesiol,2010,23(1):34-40.
  • 7Kimberger O,Arnberger M,Brandt S,et al.Goal-directed colloid administration improves the microcirculation of healthy and perianastomotic colon.Anesthesiology,2009,110(3):496-504.
  • 8Gaieski DF,Band RA,Abella BS,et al.Early goal-directed hemodynamic optimization combined with therapeutic hypothermia in comatose survivors of out-of-hospital cardiac arrest.Resuscitation,2009,80(4):418-424.
  • 9Kehlet H,Bundgaard-Nielsen M.Goal-directed perioperative fluid management:why,when,and how?Anesthesiology,2009,110(3):453-455.
  • 10Roche AM,Miller TE.Goal-directed or goal-misdirected-how should we interpret the literature?Crit Care,2010,14(2):129.

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