甘露醇用于颅脑外科手术患者液体反应性试验的可靠性  

Reliability of mannitol for fluid responsiveness test in patients undergoing intracranial surgery

作　　者：邵欣欣[1] 江楠[1] 杨璐[1] 黄贤君[1] 牛丽君[1] 肖亮灿[1] 

机构地区：[1]中山大学附属第一医院麻醉科,广州市510080

出　　处：《中华麻醉学杂志》2015年第4期457-459,共3页Chinese Journal of Anesthesiology

基　　金：广东省自然科学基金（S2012010010965）;广东省科技计划项目（2011B031800276）

摘　　要：目的 评价甘露醇用于颅脑外科手术患者液体反应性试验的可靠性.方法 择期行颅脑外科手术患者62例,性别不限,年龄18～64岁,ASA分级Ⅰ或Ⅱ级,体重指数18～25 kg/m2,麻醉诱导后行机械通气,行中心静脉和桡动脉穿刺置管术,连接FloTracTM/VigileoTM监测系统,用于监测每搏量变异度.输注甘露醇前根据每搏量变异度确定有效循环血容量水平.液体反应性试验：颅骨钻孔时开始静脉输注20％甘露醇,经20 min输注250 ml,记录输注甘露醇结束时液体反应性试验情况.结果 液体反应性试验的灵敏度和特异度分别为43％和44％.结论 甘露醇不适用于颅脑外科手术患者液体反应性试验.Objective To evaluate the reliability of mannitol for fluid responsiveness test in the patients undergoing intracranial surgery.Methods Sixty-two ASA physical status Ⅰ or Ⅱ patients,aged 18-64 yr,with body mass index of 18-25 kg/m2,scheduled for elective intracranial surgery,were enrolled in the study.The patients were mechanically ventilated after induction of anesthesia.The radial artery and central vein were cannulated,and FloTracTM/VigileoTM system was connected for stroke volume variation monitoring.Before infusion of mannitol,effective circulating blood volume was confirmed according to stroke volume variation.20％ mannitol 250 ml was infused over 20 min starting from onset of craniotomy.The fluid responsiveness test was recorded at the end of mannitol infusion.Results The sensitivity of fluid responsiveness test was 43％,and the specificity of fluid responsiveness test was 44％.Conclusion Mannitol can not be used for fluid responsiveness test in the patients undergoing intracranial surgery.

关 键 词：甘露醇 诊断试验 常规 补液疗法 神经外科手术 

分 类 号：R614[医药卫生—麻醉学]