Swan-Ganz漂浮导管用于背驮式肝移植术不同时段的容量管理  

Swan-Ganz swift catheter used in the volume management at different time-points during piggyback liver transplantation

作　　者：郑永顺 刘晓峰 王尔敦 王青君 庞伟斌 闫清 

机构地区：[1]解放军401医院麻醉科,山东青岛266071

出　　处：《实用医药杂志》2015年第1期23-25,共3页Practical Journal of Medicine & Pharmacy

摘　　要：目的通过应用漂浮导管监测背驮式肝移植患者的心、肺血流动力学指标,分析背驮式肝移植患者不同时段的容量管理。方法选择117例肝移植患者,随机分为Ⅰ、Ⅱ两组。Ⅰ组:术中适量控制输液及血液制品;Ⅱ组:大容量输注晶、胶体及血液制品。两组均应用血管活性药物维持麻醉平稳,经颈内静脉置放Swan-Ganz漂浮导管成功,监测术前(T1)、无肝期前5 min(T2)、无肝期30 min(T3)、新肝期30 min(T4)中心静脉压(CVP)、肺动脉楔压(PCWP)、心排量(CO)、右心室舒张末期容积指数(RVEDVI)、输入量、出血量及尿量。结果两组患者入、出总量及血流动力学等指标有显著性差异(P<0.05)。结论大容量输注不利于背驮式肝移植术的麻醉管理。Objective Through using Swan-Ganz swift catheter in monitoring the hemodynamie variables of piggyback liver transplantation patients to analyze the volume change at different time-points. Methods The 117 cases to be subjected to the liver transplantation were randomly divided into two groups：Group l：moderately control the infusion of fluid and blood products. Group 2：infuse large volume of erystalloids,colloids and blood- based products. Two groups all received vascular activated drugs to maintain their haemostatics. After successfully placed the Swan-Ganz swift catheter via internal jugular vein,CVP,PCWP,CO,RVEDVI,infusion volume,blood loss volume and urine output in following four time points：reoperation （Tl）,Smin （T2）. 30min （T3） after liver amputation,and 30min （T4） after the liver transplantation. Results The statistical difference significance is remarkable in the total input,output,hemodynamic variables between two groups （P〈0.05）. Conclusion The large volume infusion in piggyback liver transplantation is not helpful to anesthesia management.

关 键 词：Swan-Ganz漂浮导管 背驮式肝移植术 容量管理 

分 类 号：R657.3[医药卫生—外科学]