摘要
采用Ｓｗａｎ－Ｇａｎｚ漂浮导管，对１４例同时行迷宫和二尖瓣手术的风湿性心脏病慢性心房颤动（简称房颤）患者在术前和术后２４ｈ、４８ｈ及１个月进行血液动力学监测。结果：①术后２４ｈ、４８ｈ、１个月的心输出量（ＣＯ）、心脏指数（ＣＩ）、每搏指数（ＳＩ）、体循环阻力指数（ＳＶＲＩ）、左室每搏作功指数（ＬＶＳＷＩ）和右室每搏作功指数（ＲＶＳＷＩ）与术前比较差异有显著性（Ｐ＜０．０５～０．０００１）。②心率（ＨＲ）、平均动脉压（ＭＡＰ）、平均肺动脉压（ＭＰＡＰ）、肺动脉毛楔压（ＰＡＷＰ）、中心静脉压（ＣＶＰ）、左心作功指数（ＬＣＷＩ）、肺循环阻力指数（ＰＶＲＩ）、右心作功指数（ＲＣＷＩ）等，术后与术前以及不同时间之间比较均无统计学意义，Ｐ＞０．０５。③ＭＰＡＰ、ＰＡＷＰ、ＣＯ、ＣＩ、ＳＩ、ＳＶＲＩ、ＬＶＳＷＩ的异常发生率术后１个月与术前比较有显著性差异，Ｐ＜０．０５、＜０．０１或＜０．０００１。迷宫术后ＣＯ较术前明显提高，左房压力恢复正常，肺血管压力降低。以上表明风湿性心脏病慢性房颤迷宫和二尖瓣术后ＣＯ、左心功能均有明显改善，无围术期死亡和严重并发症，提示血液动力学监测对及时了解泵功能状态、指导治疗和评价手术疗效是非常?
Perioperative hemodynamic monitoring was performed in 14 patients with maze procedure and mitral valve operation by a 7 F Swan Ganz catheter whose tip was positioned in the pulmonary artery.Hemodynamic parameters were measured at 4 time points which were preoperative points and postoperative 24 h,48 h and 1 month.Results:(1)Comparing preoperative hemodynamic to those of postoperative 24 h,48 h,1 month,there were significant difference in CO,CI,SI,SVRI,LVSWI and RVSWI ( P <0.05～0 0001),which showed significant improvement after operation.(2)There were no significant different in HR,MAP,MPAP,PAWP,CVP,LCWI,RVRI and RCWI( P >0.05).(3)Comparing postoperative 1 month to preoperation,MPAP,PAWP,CO,CI,SI,SVRI,LVSWI were significant lower in the incidence of abnormal values( P <0.05～0 0001).These showed there was significant improvement in hemodynamic following treatment of atrial fibrillation to normal sinus rhythm,including the incerase in cardic output and decrease in pulmonary pressure and vascular resistance.Conclusion:After concomitant of mitral valve operation and maze procedure,14 patients have had significant improvement in hemodynamics.The perioperative hemodynamic monitering is benefical to diagnosis and treatment of postoperation.
出处
《中国心脏起搏与心电生理杂志》
1996年第4期180-182,共3页
Chinese Journal of Cardiac Pacing and Electrophysiology
关键词
风湿性心脏病
心房颤动
血液动力学
迷宫手术
Heart disease
rheumatic Atrial fibrillation Hemodynamic Maze procedure Mitral valve operation
