麻醉前快速超声评估及术中经食道超声心动图监测对急危重患者手术麻醉的临床指导作用  

Preoperative Rapid Ultrasound Evaluation and Intraoperative Transesophageal Echocardiographic Monitoring for the Clinical Guidance of Anesthesia in Critically Ill Patients

作　　者：余璇[1] 卢彬[1] 李强[1] 曹露 范彬[1] YU Xuan;LU Bin;LI Qiang;CAO Lu;FAN Bin(Department of Anesthesiology,Fourth People’s Hospital of Zigong City,Zigong 643000,Sichuan,P.R.China)

机构地区：[1]自贡市第四人民医院麻醉科,四川自贡643000

出　　处：《影像科学与光化学》2021年第4期595-600,共6页Imaging Science and Photochemistry

基　　金：四川省卫健委基金资助项目(18ZD024);四川省医学会科研青年创新课题(Q15030);自贡市科技局重点项目(2016SF03);自贡市科技局重点项目(2020ZC10)。

摘　　要：本文探讨麻醉前快速超声评估及术中经食道超声心动图监测对急危重患者的手术麻醉管理是否有临床指导意义。60例急危重手术患者根据随机数字表法分为对照组(麻醉医生经验评估处理)和观察组(经胸超声和经食道超声扫查评估处理)。比较两组患者液体出入量、血管活性药物使用种类及剂量、术后拔管时间等情况。研究发现,观察组患者术中使用血管活性药物的种类显著多于对照组(P<0.05);观察组出室时的血管活性药物减量的患者显著多于对照组(P<0.05);观察组患者出室时的血压显著高于对照组(P<0.05);观察组患者术中的尿量显著多于对照组(P<0.05);观察组患者术后拔管时间显著早于对照组(P<0.05)。因此,术中经食道超声心动图监测对于急危重手术患者术中的液体治疗及血管活性药物的使用有指导意义。The purpose of this research was to investigate whether the technology has clinical significance in critically ill patients.A total of 60 critically ill patients were randomly divided into the control group(based on the experience assessment of anesthesiologists)and the observation group(based on the assessment of ultrasound and transesophageal echocardiography monitoring).The outcomes were fluid volume,type and dosage of vasoactive drugs intraoperative,and the time of extubation after operative.The results showed that the types of vasoactive drugs in the observation group were significantly more than those in the control group(P<0.05).The reduction of vasoactive drugs patients in the observation group was significantly more than those in the control group(P<0.05).In terms of blood pressure,the observation group was significantly higher than that of the control group when leaving the operation room(P<0.05).For the urine volume,observation group was significantly higher than that of control group during the operation(P<0.05).The extubation time in the observation group was significantly shorter than that in the control group(P<0.05).Therefore,the preoperative rapid ultrasound evaluation and intraoperative transesophageal echocardiographic monitoring had clinical significance for the clinical guidance of anesthesia in critically ill patients.

关 键 词：经胸超声评估 经食道超声评估 急危重患者 手术 麻醉 

分 类 号：R614[医药卫生—麻醉学]