每搏量变异度与单肺通气患者血容量变化的相关性  

Correlation between stroke volume variation and blood volume during one-lung ventilation

作　　者：王合梅[1] 李超[1] 雍芳芳[1] 贾慧群[1] 

机构地区：[1]河北医科大学第四医院麻醉科,石家庄市050011

出　　处：《中华麻醉学杂志》2012年第11期1374-1375,共2页Chinese Journal of Anesthesiology

基　　金：河北省普通高等学校强势特色学科肿瘤学建设经费资助项目;河北省科技厅指令性课题（07276101D-106）

摘　　要：目的探讨每搏量变异度（SVV）与单肺通气患者血容量变化的相关性。方法择期拟行食管癌切除术患者40例，男性，年龄50～60岁，体重指数20～25kg／m2，ASA分级Ⅱ级。麻醉诱导后经口明视插入F39右侧双腔支气管导管，经两肺听诊和纤维支气管镜定位后，连接麻醉机行单肺通气，设定潮气量8ml／kg、呼吸频率15次／min、吸呼比1：2。单肺通气30rain时静脉输注6％羟乙基淀粉130／0．4，速率为0．67ml·kg·min^-1，分别在输注前、输注羟乙基淀粉剂量达2、4、6、8、10、12ml／kg时采用FloTrac／Vigileo心输出量监测系统记录SVV、CO、SV、CI。SVV、CO、SV、CI与羟乙基淀粉输注量行Spearman等级相关分析。结果SVV与单肺通气患者血容量变化呈负相关，CI、CO、SV与单肺通气患者血容量变化呈正相关（P〈0．05），相关系数（r）分别为rSVV：-0．249，rCO：0．570，rSV：0．552，rCI：0．550。结论SVV与单肺通气患者血容量变化相关性差，不能准确反映容量的变化。Objective To evaluate the correlation between stroke volume variation （SVV） and blood vol- ume during one-lung ventilation （OLV）.Methods Forty ASA li male patients, aged 50-60 yr, with body mass index 20-25 kg/m2 , scheduled for elective resection of esophageal cancer, were studied. Anesthesia was induced with fentanyl 4μg/kg, propofol 2 mg/kg, and rocuronium 0.6 mg/kg. Double-lumen tube was inserted. Correct position was verified by fiberoptic bronchoscopy. The patients were mechanically ventilated （V.r 8 ml/kg, RR 15 bpm, I：E 1：2）. 6% hydroxyethyl starch （HES） 130/0.4 was infused intravenously at a rate of 0.67 ml·kg^-1 .min^-1 starting from 30 min of OLV. SVV, cardiac output （CO） , SV and cardiac index （CI） were mon- itored and recorded using the FloTrae/Vigileo （Edwards Lifesciences, USA） system before HES was infused and when the dose of HES reached 2, 4, 6, 8, 10 and 12 ml/kg. Spearman rank sum correlation coefficient was used to analyze the data. Results SVV was negatively correlated with the blood volume during OLV and the correlation coefficient was rsvv = - 0.249. CI, CO and SV were positively correlated with the blood volume during OLV and the correlation coefficients were rco = 0.570, rsv = 0.552 and rcj = 0.550, respectively. Conclusion SVV is poorly correlated with the blood volume during OLV and can not reflect the blood volume accurately.

关 键 词：每搏输出量 血管容量 呼吸 人工 

分 类 号：R614[医药卫生—麻醉学]