摘要
目的和方法 :4 0例肾移植病人在硬膜外麻醉前放置Swan Ganz导管行围术期血流动力学分析。结果 :硬膜外阻滞 3 0分钟 ,MAP、CVP、体循环阻力 (SVR)下降明显 (P <0 0 5 ) ,而其他指标无明显变化。髂内动脉阻断后 ,MAP、CVP逐渐恢复至麻醉前水平 ,而肺循环阻力 (PVR)则明显升高 (P <0 0 5 )。开放供肾血流 2 0分钟内血流动力学变化较大。心输出量 (CO)、心脏指数 (CI)显著增加 (P <0 0 1) ,平均肺动脉压 (MPAP)、PVR升高显著 (P <0 0 5 ) ,而CVP、SVR及右室每搏功指数 (RVSWI)明显降低 (P <0 0 5 )。开放后 60分钟 ,循环趋于稳定 ,但CVP比麻醉前明显降低 ,MPAP、CO、PVR比麻醉前高 (P <0 0 5 )。结论 :肾移植围术期血流动力学变化随手术步骤而不同 。
Objective and methods: 40 patients of kidney transplantation under epidural anesthesia were placed Swan Ganz to monitor the changes of hemodynamics during the surgery. Results: 30 min after induction of epidural anesthesia, MAP、CVP and SVR decreaded significantly (P<0 05). During clamping of the arteria iliaca interna, MAP and CVP rose slowly to basal level, while PVR increased markedly (P<0 05).20 min after relief of the clamp for blood supply to new kidney, CO、CI、PVR and mean pulmonary arterial pressure (MPAP) increased markedly (P<0 05), while CVP、SVR and right ventricular systolic work index (RVSWI) dropped markedly (P<0 05).60 min later, Hemodynamics became stable. Conclusion: During kidney transplantation, the hemodynamics changes with operation procedure. The key for success of anesthesia is to adjust anesthesia accordingly.
出处
《临床麻醉学杂志》
CAS
CSCD
1999年第5期256-257,共2页
Journal of Clinical Anesthesiology
关键词
肾移植
硬膜外麻醉
血流动力学
Kidney transplantation Epidural anesthesia Hemodynamics
