神经外科手术中桡动脉与足背动脉脉压变异度的一致性分析  

Association between pulse pressure variation of radial artery and pulse pressure variation of dorsal pedal artery in neurosurgery operation

作　　者：谢卫卫[1] 马艳丽[1] 

机构地区：[1]郑州大学第一附属医院麻醉科,450052

出　　处：《临床麻醉学杂志》2017年第5期438-441,共4页Journal of Clinical Anesthesiology

摘　　要：目的探讨在神经外科手术中桡动脉与足背动脉的脉压变异度的一致性。方法选择神经外科择期开颅手术患者25例,全麻气管插管后,记录麻醉诱导后20min、去骨瓣即刻、剪开硬膜即刻、上骨瓣时的桡动脉脉压变异度(PPV1)与足背动脉脉压变异度(PPV2)。VT设置为8ml/kg,采用Bland-Altman法分析PPV1与PPV2的一致性。结果 Bland-Altman分析显示:PPV1与PPV2麻醉诱导后20 min平均偏差0.5%(-1.9%~2.8%);去骨瓣即刻平均偏差-0.5%(-3.8%~2.9%);剪开硬膜即刻平均偏差-0.1%(-3.2%~3.0%);上骨瓣时平均偏差0.1%(-2.4%~2.6%)。结论与桡动脉脉压变异度一样,足背动脉脉压变异度对于神经外科开颅手术中的容量监测及容量治疗有指导意义。Objective To discuss the agreement between pulse pressure variation of radial artery and pulse pressure variation of dorsal pedalartery in neurosurgery. Methods Twenty-five pa- tients undergoing selective craniotomy under general anesthesia were enrolled. The following data were monitored and recorded respectively after tracheal intubation general anesthesia under different time：radial artery pulse pressure variability （PPV1） and dorsalis pedis pulse pressure variation （PPV2）. Tidal volume was set to 8 ml/kg. Bland-Altman plots were created to assess agreement be- tween PPV1 and PPV2. Results The mean differences and the limits of agreement between PPV1 and PPV2 are 20 min after induction of anesthesia 0.5% （ - 1.9%-2.8%）, boneless flap instantly -0. 5% （-3.8%-2.9%）, Cut the dura mater instantly --0.1% （-3.2%-3.0%）, and bone flap 0. 1% （-2.4%-2.6%）. Conclusion Dorsal pedal artery pulse pressure variation in neurosurgery craniotomy has certain guiding significance to the monitoring and management.

关 键 词：神经外科 桡动脉 足背动脉 脉压变异度 Bland-Altman法 

分 类 号：R614[医药卫生—麻醉学]