术前急性超容血液稀释对胸阻抗的影响  

Influence of acute hypervolemic hemodilution on thoracic electrical impedance

作　　者：马伟[1] 许海芳[1] 周曙[1] 金珏[1] 于布为[1] 

机构地区：[1]上海第二医科大学附属瑞金医院麻醉科,200025

出　　处：《临床麻醉学杂志》2002年第2期71-73,共3页Journal of Clinical Anesthesiology

摘　　要：目的　通过术前急性超容血液稀释 ,观察急性血容量变化引起的胸部电阻抗的改变 ,以探讨用胸阻抗法评估血容量变化的可行性。方法　 10例接受择期手术的成年患者 ,术中平卧位 ,全麻气管内插管后 ,分别记录 10分钟内快速输液至 10ml/kg和 2 0ml/kg时高频 ( 10 0kHz)和低频( 1 5kHz)两种电流下胸阻抗的变化以及心输出量、肺动脉压等血液动力学参数。结果　与输液至10ml/kg时相比 ,术前快速输液达 2 0ml/kg时 ,低频、高频胸阻抗分别由 ( 5 2 2 7± 8 89)Ω和 ( 4 0 62±7 10 )Ω降至 ( 4 9 93± 8 86)Ω和 ( 3 8 4 2± 7 12 )Ω ,胸阻抗指数由 5 5 5 6± 11 93上升至 5 8 89±13 5 7(P <0 0 5 )。CVP、PAP、PCWP均显著增加 ,而Hb、Hct则明显减少 (P <0 0 5 )。结论　胸阻抗的监测能有效地评估急性血容量增加。Objective To assess the feasibility of using thoracic electrical impedance to estimate the central circulatory volume.Methods Ten patients undergoing abdominal surgery were enrolled in this study.After general anesthesia induction and tracheal intubation,at the time points of 10ml/kg and 20ml/kg liquid infusion reached,the low frequency impedience (Zl)and high frequency impedience (Zh) of thoracic impedance were measured and the hemodynamics recorded respectively.Results After acute hypervolemic hemodilution,the Zl and Zh decreased from (52 27±8 89)Ω and (40 62±7 10)Ω to (49 93±8 86)Ω and (38 42±7 12)Ω,the conductance of intracellular water (ICW) increased from (55 56±11 93)s to (58 89±13 57)s ( P< 0 05).CVP,PCWP,CO and PAP were increased,and Hb,Hct decreased significantly ( P< 0 05).Conclusion Thoracic electrical impedance is useful in the estimation of acute blood volume variation.

关 键 词：血液稀释 胸部电阻抗 血容量 术前急性超容血液稀释技术 

分 类 号：R614[医药卫生—麻醉学]