彩超监测开颅血肿清除术全麻患者股动脉血流动力学的意义  

Monitoring of femoral artery hemodynamics in acute cerebral hemorrhage patients under general anesthesia by color doppler ultrasound

作　　者：张渺[1] 张振英[1] 

机构地区：[1]新疆石河子大学医学院第一附属医院麻醉科,新疆石河子832000

出　　处：《局解手术学杂志》2016年第3期191-194,共4页Journal of Regional Anatomy and Operative Surgery

摘　　要：目的探索彩超监测急性颅脑损伤全麻者股动脉血流动力学变化的临床意义。方法选择急诊全麻行开颅颅内血肿清除术患者30例,所有患者均行全麻诱导气管插管。采用彩超观察并记录麻醉诱导前、麻醉诱导后、插管即刻、剪开硬脑膜后、皮瓣缝合后的股动脉血流收缩期峰值速度(Vs)、舒张早期反向波峰值速度(Vd)、收缩期内径(Ds)、舒张期内径(Dd)及收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)和心率(HR)的变化。结果与麻醉诱导前相比,各时间点MAP、Vd、Vs均降低(P<0.05),Ds、Dd增大(P<0.05);麻醉诱导后相比,插管即刻MAP升高,Vs降低,Vd升高(P<0.05),Ds、Dd变化无统计学意义;与插管即刻相比,打开硬脑膜后MAP下降,Vs、Vd降低,Ds、Dd增大(P<0.05);各时间点HR变化无统计学意义(P>0.05)。结论彩超可以反应急性颅脑损伤全麻患者股动脉血流动力学变化,对全身麻醉管理有一定的指导意义。Objective To explore the clinical significance of monitoring the femoral artery hemodynamics of acute cerebral hemorrhage patients under general anesthesia by color doppler ultrasound. Methods Totally 30 patients who received emergency craniotomy for intracranial hematoma were performed the induction of general anesthesia and endotracheal intubation. The changes of femoral artery peak systolic velocity（ Vs）,early diastolic reverse peak velocity（ Vd）,systolic diameter（ Ds）,diastolic diameter（ Dd）,systolic blood pressure（ SBP）,diastolic blood pressure（ DBP）,mean arterial pressure（ MAP） and heart rate（ HR） at each time point of before and after anesthesia induction,intubation,cutting the endocranium,suturing the flaps were observed and recorded. Results Compared with those before anesthesia induction,the MAP,VD and Vs were decreased（ P〈0. 05）,DS and DD increased（ P〈0. 05） at each time point. Compared with those after anesthesia induction,MAP and VD increased,VS reduced（ P〈0. 05） at the intubation moment,the changes of DS and DD was not statistically significant,which compared with those after cutting the endocranium,MAP,VS and VD decreased,but DS and DD increased（ P〈0. 05）. The changes of HR at each time point was not statistically significant（ P〉0. 05）. Conclusion Color doppler ultrasound could reflect the femoral artery hemodynamics of patients who subjected to craniotomy for intracranial hematoma under general anesthesia,which provides some guidance for the general anesthesia strategies.

关 键 词：彩超 颅脑损伤 全身麻醉 股动脉 血流动力学 

分 类 号：R651.15[医药卫生—外科学]