胸阻抗无创心排监测在老年患者股骨头置换术中的临床应用  

Clinical Application of Thoracic Impedance Noninvasive Cardiac Output Monitoring in Elderly Patients with Femoral Head Replacement

作　　者：陈伟元[1] 王焕彬[1] 张彩玲[1] 

机构地区：[1]梅州市人民医院田家炳医院麻醉三科,广东梅州514031

出　　处：《黑龙江医学》2015年第9期1023-1024,共2页Heilongjiang Medical Journal

基　　金：梅州市医药卫生科研课题(2014-B-12)

摘　　要：目的 探讨胸阻抗无创心排监测在老年患者股骨头置换术中临床应用效果。方法 选取2013-01～2014-07间我院收治80例股骨头置换术老年患者为研究对象,随机分为观察组和对照组。对照组采用常规连接心电监护,观察组采用胸阻抗无创心排监测,比较两组患者在麻醉前10 min、麻醉10 min后、麻醉20 min后、麻醉30 min后各时间段血流动力学、输液总量和尿量。结果 观察组在麻醉前10 min CO值和对照组比较,差异无统计学意义（P〉0.05）,麻醉10 min后、麻醉20 min后、麻醉30 min后及扩髓腔后,观察组CO值均高于对照组,差异有统计学意义（P〈0.05）;观察组输液总量明显少于对照组,差异有统计学意义（P〈0.05）;观察组患者排尿总量和对照组比较无明显差异（P〉0.05）。结论 在老年患者股骨头置换术中应用胸阻抗无创心排监测可有效监测血流动力学,有效地指导术中输液用药,保持血液动力学稳定,确保手术安全。Objective To investigate the clinical application effect of thoracic impedance noninvasive cardiac output monitoring in elderly patients with femoral head replacement. Methods Selecting 80 elderly patients with femoral head replacement as the object of study from January, 2013 to July, 2014 in the hospital, and randomly dividing them to observation group and control group. The control group used conventional connection ECG monitoring, and the observation group used thoracic impedance noninvasive cardiac monitoring, Hemodynamics, the total level of infusion and urine volume of patients of two groups 10min before anesthesia, 10min, 20min, 30min after anesthesia were compared. Results 10min before anesthesia CO value of the observation group and control group had no statistical significance （P 〉 0. 05） ; 10min, 20min, 30rain after anesthesia and expansion of marrow cavity, the CO value of the observation group was higher than that of the control, with statistical significance（P 〈 0. 05 ）; the total amount of transfusion observation group was significantly less than that of the control group, with statistical significance （ P 〈 0. 05 ） ; urinary total in the observation group and the control group had no significant difference（P 〉 0. 05 ）. Conclusion Thoracic impedance uoninvasive cardiac output monitoring in elderly patients with femoral can effec- tively monitor hemodynamics of bone replacement, and effectively guide the intraoperative transfusion, maintain hemodynamic stability, and improve the operation safety.

关 键 词：胸阻抗无创心排监测 老年患者 股骨头置换术 

分 类 号：R614[医药卫生—麻醉学]