FloTrac/Vigileo系统在大面积烧伤患者早期切痂手术中的应用  

The application of FloTrac/Vigileo system in the large area burn patients undergoing early excision of eschar surgery

作　　者：许福生[1] 吴志云[1] 吴财能[1] 

机构地区：[1]中国人民解放军第180医院麻醉科,福建省泉州市362000

出　　处：《临床麻醉学杂志》2014年第3期254-256,共3页Journal of Clinical Anesthesiology

摘　　要：目的探讨FloTrac/Vigileo系统在大面积烧伤患者早期切痂手术中指导容量治疗的安全性和有效性。方法 80例接受手术治疗的大面积烧伤患者随机均分为两组。研究组采用FloTrac/Vigileo系统连续监测患者的每搏变异度(SVV)、心排血量(CO)、心脏指数(CI)、全身血管阻力(SVR)等的变化,根据其变化情况,术中做相应的处理;对照组采用迈瑞BeneViewT8监护仪进行CVP、MAP、SpO2等监测,根据CVP的监测值及术中情况对患者采取相应的处理。监测和记录两组患者麻醉诱导前、手术开始1h、术毕和拔管时的CVP、MAP、HR,记录烧伤重症监护室(BICU)入住时间、急性心功能不全、急性呼吸窘迫综合征(ARDS)的发生率。结果治疗组患者CVP、MAP明显高于,HR明显慢于对照组(P<0.05);治疗组BICU入住时间明显短于,ARDS和急性心功能不全的发生率明显低于对照组(P<0.05)。结论 FloTrac/Vigileo系统对指导大面积烧伤患者早期切痂手术补液治疗是安全、有效的。Objective To investigate the efficacy and safety of FloTrac/Vigileo system on the volume therapy guiding in the operation treatment of large area burned patients.Methods Eighty cases of large area burned patients were equally randomized into research group and control group.FloTrac/Vigileo system was used in the research group to monitor the stroke patients continuously in heart rate variability （SW）,cardiac output （CO）,cardiac index （CI）,systemic vascular resistance （SVR） changes and corresponding treatment was made according to the change in the operation.Mindray BeneViewT8 was used in the control group to monitor the CVP,MAP,SpO2.Corresponding processing was taken according to the value of CVP and the situation of patients during operation.Then postoperative CVP,MAP,HR,BICU time,acute left heart failure incidence,the incidence rate of ARDS was recorded in both groups.Results Postoperative MAP and CVP in the research group were higher than those in the control group,while HR,BICU discharge time,incidence of ARDS were significantly lower than those in the control group （P ＜ 0.05）.Conclusion It is an efficacy and safe method to use FloTrac/Vigileo system early for guiding fluid therapy in Escharectomy operation for large area burned patients.

关 键 词：FloTrac Vigileo系统 大面积烧伤 早期切痂手术 

分 类 号：R644[医药卫生—外科学]