降低体表温度在体外循环后血管麻痹综合征患者治疗中应用的效果评价  

Application of induced hypothermia in vasoplegia syndrome after postcardiopulmonary bypass

作　　者：王瑛[1] 于文舟[2] 

机构地区：[1]潍坊医学院,261053 [2]山东省潍坊市人民医院心血管外科

出　　处：《中国实用护理杂志》2014年第18期38-40,共3页Chinese Journal of Practical Nursing

摘　　要：目的总结降低体表温度在体外循环后血管麻痹综合征中的应用效果。方法在调整血容量，应用大剂量缩血管药物基础上使用变温毯治疗血管麻痹综合征。记录不同时段患者的体表温度，记录心率、收缩压、平均动脉压、中心静脉压、血氧饱和度、尿量，体循环阻力（SVR）、肺循环阻力（PVR）和心输出量（CO）等指标，分析降低体表温度的应用效果。结果应用体表降温后血压升高，心率降低，SVR逐渐增高，尿量增加，中心静脉压、血氧饱和度无显著变化。结论降低体表温度可升高血压，减少缩血管药物的用量，在某些病例中可起到决定性作用。降低体表温度可作为治疗体外循环后血管麻痹综合征的辅助办法。Objective To investigate the effects of induced hypothermia in vasoplegia syndrome after post-cardiopulmonary bypass. Methods 4 individuals diagnosed as CPB-induced vasoplegia syn- drome was given hypothermia by surface cooling using hypo-hyperthermia blanket based on vasopressors and adjustment of blood volume. The surface temperature, heart rate, systolic pressure, mean arterial blood pressure, central venous pressure, oxygen saturation of blood, urine volume, systemic vascular resistance （SVR）, pulmonary vascular resistance （PVR） and cardiac output （CO） were recorded. Results Systemic vascular resistance gradually improved along with normalization of cardiac output, and increased mean arte- rial blood pressure. Conclusions The mild hypothermia can increase blood pressure, decrease dosage of vasopressors, and may play a decisive role in some cases. So mild hypothermia may be an effec-tive alternative to treat CPB-induced vasoplegia syndrome.

关 键 词：血管麻痹综合征 体外循环 心脏手术 

分 类 号：R473.6[医药卫生—护理学]