脊柱侧弯矫正术中液体入量对血管外肺水及术后呼吸功能的影响  

Study of correlation between amount of transfusion and extravascular lung water include respiratory function in scoliosis surgery

作　　者：张萍[1] 郑曼[1] 张媛[1] 徐颖[2] 肖永龙[3] 

机构地区：[1]南京大学附属鼓楼医院麻醉科,江苏南京210008 [2]南京大学附属鼓楼医院危重病医学科,江苏南京210008 [3]南京大学附属鼓楼医院呼吸科,江苏南京210008

出　　处：《东南大学学报（医学版）》2010年第5期542-545,共4页Journal of Southeast University(Medical Science Edition)

基　　金：南京市卫生局课题项目(ZKM05050)

摘　　要：目的:探讨脊柱侧弯患者后路矫形手术中液体输入对血管外肺水(EVLW)及术后呼吸功能的影响。方法:选择20例青少年特发性脊柱侧弯患者,行静吸复合全身麻醉,放置PICCO导管术中监测EVLW,于拔除气管导管前行动态肺顺应性(Cdyn)监测。记录术毕晶胶体入量、EVLW指数(EVLWI)、Cdyn及术后拔管时间。结果:脊柱侧弯后路矫形术中晶体液、胶体液量及液体总量均与EVLW呈线性相关(Pearson相关系数>0.6,P<0.05),而术毕液体总入量与EVLW独立相关(P<0.05)。EVLW与Cdyn、Cdyn与拔管时间呈负相关(Spearman相关系数为负值,P<0.05)。结论:脊柱侧弯后路矫形术中,液体总入量是患者EVLW增加的独立预测因素;液体总入量的增加可降低术后肺顺应性,延长术后拔管时间。Objective： To investigate the correlation between the amount of transfusion fluids and extravascular lung water（EVLW） include respiratory fuction in scoliosis surgery. Methods： Twenty patients received general anesthesia scheduled for Scoliosis Surgery were mornitored continuously by PiCCO deviced, measured extravascular lung water index （ EVLWI ） ; and at the same time, the amount and kinds of transfusion fluids, dynamic lung compliance and trachea canula extubated time were recorded during operation. Results： Amount of colloid solution, amount of crystalloid solution and total amount of transfusion were significantly correlated with EVLWI （ Pearson correlation coefficient 〉 0.6, P 〈 0.05 ）, but total amount of transfusion was the independent predictor of EVLWI（P 〈0.05）. There was significantly negatively correlation between EVLWI and dynamic lung compliance, between dynamic lung compliance and trachea canula extubated time （ P 〈 0.05, Spearman correlation coefficient was negative number）. Conclusion： Total amount of transfusion during scoliosis surgery is the independent predictor of EVLWI. Increase the amount of transfusion can depress dynamic lung compliance and delay trachea canula extubated time.

关 键 词：术中输液 脊柱侧弯 血管外肺水 动态肺顺应性 

分 类 号：R619.4[医药卫生—外科学]