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肺科手术中扩容对血管外肺水和肺渗透性的影响 被引量:1

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摘要 目的探讨在单肺通气(OLV)下肺叶切除患者中行急性超容量血液稀释(AHHD)对血流动力学及肺血管外肺水、肺渗透性的影响。方法选取OLV下行肺叶切除患者12例行AHHD,选用6%万汶(羟乙基淀粉130/0.4氯化钠)15ml/kg在麻醉诱导后30min内输注完毕。术中监测中心静脉压(CVP)、血红蛋白(Hb)、血细胞比容(Hct),并动脉采血行血气分析。经股动脉放置PICCO(PV2014L13,pulson medical systems)热稀释导管,监测平均动脉压(MAP)、心指数(CI)、全心舒张末期容积指数(GEDVI)、胸腔内血容量指数(ITBVI)、血管外肺水指数(EVLWI)、肺通透性变化指数(PVPI)等参数。观察麻醉前、稀释一半、稀释结束及术毕各参数变化。记录出血、输液及输血量,观察尿量。结果稀释后CI,GEDVI,ITBVI明显增加(P<0.05),EVLWI,PVPI轻度增高(P>0.05);Hb和Hct较稀释前无显著差异;血气分析结果基本正常。结论在单肺通气下行肺叶切除患者中,采用6%万汶(羟乙基淀粉130/0.4氯化钠)15ml/kg行血液稀释既可保证血容量,又不增加心脏前负荷;对EVLWI,PVPI无明显影响。
出处 《广东医学》 CAS CSCD 北大核心 2007年第12期1937-1938,共2页 Guangdong Medical Journal
基金 广东省科技项目(编号:2005B30601005)
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共引文献91

同被引文献21

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