FloTrac/Vigileo系统用于单肺通气血流动力学的监测  

Application of FloTrac/Vigileo system in monitoring hemodynamics of single lung ventilation

作　　者：杨梦[1] 解雅英[1] 都义日[1] YANG Meng , XIE Yaying , DU Yiri(Department of Anesthesiology, The Affiliated Hospital of Inner Mon- golia Medical University, Hohhot 010050, Chin)

机构地区：[1]内蒙古医科大学附属医院麻醉科,呼和浩特市010050

出　　处：《临床麻醉学杂志》2018年第3期267-270,共4页Journal of Clinical Anesthesiology

摘　　要：目的探讨Flo Trac/Vigileo系统在单肺通气患者术中血流动力学监测的可行性。方法选取全麻胸腔镜下肺叶切除术患者25例,年龄35~65岁,ASAⅠ或Ⅱ级,术前无Flo Trac/Vigileo系统及经食管超声心动图(TEE)应用禁忌证。入室行桡动脉穿刺置管,连接Flo Trac/Vigileo系统,并于全麻诱导后置入TEE探头。分别同时采用Flo Trac/Vigileo系统与TEE监测并记录侧卧翻身后(开胸前,T0)、开胸单肺通气即刻(T1)、单肺通气15 min(T2)、单肺通气30 min(T3)、单肺通气45min(T4)、单肺通气60 min(T5)的SV、CO、SVV(Flo Trac/Vigileo系统)或c IVC(TEE监测)。其中由Flo Trac/Vigileo系统所测的SV和CO等记作SVF、COF;由TEE所测的记作SVT、COT。结果 T0~T5时SVF和SVT差异无统计学意义;整体相关性分析,相关系数r=0.84,P<0.01。T0~T5时COF和COT差异无统计学意义;整体相关性分析,相关系数r=0.92,P<0.01。SVV和的c IVC整体相关性分析,结果呈正相关,相关系数r=0.80,P<0.01。结论 Flo Trac/Vigileo系统可在胸科手术中作为术中血流动力学的监测方法。Objective To explore the feasibility of FloTrac/Vigileo System in hemodynamic monitoring during the surgery of single-lung ventilation patients. Methods Twenty-five patients with thoracoscopic lobectomy under general anesthesia, aged 35-65 years, ASA physical status Ⅰ or Ⅱ, preoperative showed no application taboo of FloTrac/Vigileo system or transesophageal echocardiography （TEE）. The radial artery puncture catheter was inserted after getting into the operating room, then connect the FloTrac/Vigileo system, after that the TEE was inserted following the induction of general anesthesia. Using the FloTrac/Vigileo system to record the stroke volume （SVF）, cardiac output （COF）, stroke volume variation （SVV）, at the moment of after turning over （T0）, opening chest and single-lung ventilation （T1）, single-lung ventilation for 15 minutes （T2）, single-lung ventilation for 30 minutes （T3）, single-lung ventilation for 45 minutes （T4） single-lung ventilation for 60 minutes （T5）. Using TEE to monitor the index and record the the stroke volume （SVT） cardiac output（COT） and inferior vena cava collapse index （cIVC） of the same patient at same time as Group F. Results There was no statistically significant different between SVF and SVT at T0-T5 in both groups, Overall correlation analysis, r=0.84, P〈0.01. There is no statistically significant different between COF and COT at T0-T5 in both groups, Overall correlation analysis, r=0.92, P〈0.01. Correlation analysis of SVV of group F and cIVC of group T, the results were positively correlate, r=0.80, P〈0.01. Conclusion FloTrac/Vigileo system can be used as a monitoring method for monitoring hemodynamics in thoracic surgery.

关 键 词：FloTrac/Vigileo系统 单肺通气 血流动力学监测 每搏量变异度 

分 类 号：R614[医药卫生—麻醉学]