CO_2气腹中肾动脉阻力指数和肾血流量的变化  

Renal Resistive Index and Renal Blood Flow during Pneumoperitoneum with Carbon Dioxide

作　　者：戴双波[1] 杨平亮[2] 刘斌[3] 齐娟[1] 

机构地区：[1]福建省立医院麻醉科福建省心血管病研究所,福州350001 [2]四川大学华西第二医院麻醉科,成都610041 [3]四川大学华西医院麻醉科,成都610041

出　　处：《福建医科大学学报》2007年第6期561-564,共4页Journal of Fujian Medical University

摘　　要：目的观察CO2气腹中肾动脉阻力指数和肾血流量的变化及二者关系,探讨肾动脉阻力指数在临床监测的意义。方法择期行腹腔镜胆囊切除术(LC术)32例,术中经食管超声心动图分别于气腹前(T0),气腹1min(T1)、5min(T5)、10min(T10)、15min(T15)、20min(T20)、30min(T30),解除气腹后1min(TE1)、5min(TE5)测量左肾动脉主干内径(RAD)、左肾动脉主干血流速度(Vs、Vd、Vm)及血流速度时间积分(VTI),计算阻力指数(RI)、搏动指数(PI)、左肾血流量(LRBF)及左肾血流灌注阻力(LRPR),分析影响RI、PI的相关因素。结果与T0比较,RI、PI在T1下降(P<0.05),其余各时点间无明显变化(P>0.05);LRBF、LRPR在气腹中各时点下降(P<0.05),解除气腹后5min恢复(P>0.05)。CO2气腹中,RI、PI与LRBF、LRPR之间无直线相关关系(P>0.05),与脉压指数(PPI)、心率(HR)之间有直线相关关系(P<0.05)。结论CO2气腹中肾动脉阻力指数和肾血流量变化没有相关关系,肾动脉阻力指数不能反映肾血流量的变化。Objective To investigate the correlation between the renal resistive index and the renal blood flow during pneumoperitoneum with carbon dioxide. Methods In 32 patients for selective laparoscopic cholecystectomy, the left renal arterial diameter（RAD）, systolic velocity（Vs）, diastolic velocity （Vd）, mean velocity（Vm） and the velocity time integral（VTI） of renal artery were measured by transesophageal echocardiography before pneumoperitoneum （T0）, 1, 5, 10, 15, 20, 30 min during pneumoperitoneum, and 1, 5 rain after deflation. The resistive index（RI）, the pulsatility index（PI）, the left renal blood flow（LRBF） and the left renal blood perfuse resistance（LRPR） were calculated according to standard formulae. The correlation between RI and LRBF was analyzed. Results Compared to To, although the RI and PI were decreased at 1 min time point during pneumoperitoneum, there were almost no changes during pneumoperitoneum; otherwise LRBF was decreased and LRPR was increased during pneumoperitoneum. There was no correlation between RI, PI and LRBF, LRPR. Conclusion There is no correlation between RI and the renal blood flow during pneumoperitoneum with carbon dioxide. The RI change does not indicate the change of the renal blood flow during pneumoperitoneum with carbon dioxide.

关 键 词：肾动脉 血管阻力 气腹 肾血流量 有效 超声心动描记术 经食管 

分 类 号：R614[医药卫生—麻醉学]