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