摘要
目的观察控制性低中心静脉压(LCVP)下肝叶切除手术患者围术期心肌肌钙蛋白I(cTnI)浓度的变化,探讨LCVP对围术期心肌氧供需平衡的影响。方法 30例择期行肝叶切除术的患者随机均分为正常中心静脉压(NCVP)组(N组)和LCVP组(L组)。监测两组患者麻醉前(T1)、麻醉诱导气管插管后(T2)、肝实质离断时(T3)、手术结束即刻(T4)、术后24h(T5)的SBP和HR的乘积值(RPP)、CVP和T1～T4时心电标准监护Ⅱ导联的ST段绝对值。在T1、T4及T5时抽取外周静脉血测定血清心肌cTnI浓度。结果与T1时比较,L组T3、T4时HR明显增快(P<0.05);T2、T3时SBP、T2时RPP、T3时CVP明显降低(P<0.05);而T4时L组RPP、CVP明显升高(P<0.05)。与N组比较,L组T3、T5时SBP;T3时CVP明显降低(P<0.05)。T1～T4时两组患者ST段绝对值组内组间比较差异无统计学意义,且均在正常范围之内。T1、T4、T5时两组患者cTnI浓度组内组间比较差异均无统计学意义,并均在正常值范围之内。结论 LCVP下肝叶切除术患者围术期cTnI浓度无明显变化。
Objective To observate the concentration changes of cardiac troponin I in patients undergoing hepatolobectomy under controlled low central venous pressure （LCVP） and to evaluate the effect of LCVP on myocardial oxygen metabolism patients undergoing elective hepatolobectomy were pressure group （group N） and low central venous during perioperative period. Methods Thirty randomly divided into normal central venous pressure group （group L）. The rate-pressure products （RPP）, CVP and absolute value of ST segment on standard monitoring II lead were calculated or recorded at the following time points： before anesthesia （T1）, after induction of anesthesia （T2）, during liver parenchymal transection（T3 ）, the end of operative procedure （T4） and 24 hour after operation （T5）. The concentrations of cordial troponin I in blood serum were determined at T1, T4and T5. Results The RPP in group L decreased at T2, and increased significantly at T4, and decreased at T2-Ts in group N compared with that at T1. The values of ST segment were normal and showed no significant difference in both groups from T~ to T4. There were no significant difference of the cTnI concentration between the two groups and all values were in normal range. Conclusion There was no significant change of the cardiac troponin I concentration in patients undergoing hepatolobectomy under controlled low central venous pressure.
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2012年第10期989-991,共3页
Journal of Clinical Anesthesiology
基金
广西自然科学基金资助项目(编号:桂科自0447066)
