心肺联合超声在胸腔镜下肺叶切除术患者液体管理中的应用价值分析  

Application Value Analysis of Combined Cardiopulmonary Ultrasound in Fluid Management of Patients Undergoing Thoracoscopic Lobectomy

作　　者：高绍满 郑卫兰 GAO Shaoman;ZHENG Weilan(Shanghai Dongfang Hospital Ji’an Hospital,Ji’an 343000,China;不详)

机构地区：[1]上海市东方医院吉安医院,江西吉安343000

出　　处：《中国医学创新》2021年第17期148-151,共4页Medical Innovation of China

基　　金：2018年吉安市指导性科技计划项目(吉市科计字[2018]6号38)。

摘　　要：目的:探讨心肺联合超声在胸腔镜下肺叶切除术患者液体管理中的应用价值。方法:选择2018年5月-2020年5月86例于本院行胸腔镜下肺叶切除术患者,根据随机数字表法分为对照组和观察组,每组43例。对照组应用中心静脉导管监测中心静脉压指导液体管理,观察组使用心肺联合超声监测。比较两组术中指标、并发症发生情况及诱导时刻和术毕时的乳酸(Lac)、氧消耗指数(VO2I)、氧输送指数(DO2I)。结果:观察组尿量、输液量均多于对照组,麻黄素用量、去氧肾上腺素用量均少于对照组,差异均有统计学意义(P<0.05)。术毕时,两组Lac、VO2I、DO2I均优于诱导即刻,且观察组Lac(0.82±0.39)mmol/L,低于对照组的(2.25±0.61)mmol/L,VO2I(153.76±8.49)mL/(min·m^(2))、DO2I(572.82±13.26)mL/(min·m^(2))均高于对照组的(124.76±7.51)mL/(min·m^(2))、(542.54±25.54)mL/(min·m^(2))(P<0.05)。观察组并发症发生率为4.65%低于对照组的23.26%,差异有统计学意义(P<0.05)。结论:胸腔镜下肺叶切除术患者应用心肺联合超声监测应用价值较高,能够减少术中血管活性药物使用量,改善氧供需平衡,减少并发症的发生。Objective:To explore the application value of combined cardiopulmonary ultrasound in fluid management of patients undergoing thoracoscopic lobectomy.Method:A total of 86 patients who underwent thoracoscopic lobectomy in our hospital from May 2018 to May 2020 were selected and divided into the control group and observation group according to random number table method,43 cases in each group.The control group used central venous catheter to monitor central venous pressure to guide fluid management,and the observation group used combined cardiopulmonary ultrasound monitoring.The intraoperative indexes and the incidence of complications were compared between two groups,and the level of lactic acid(Lac),oxygen consumption index(VO2I),oxygen delivery index(DO2I)at induction time and the end of surgery were compared between two groups.Result:The urine volume and infusion volume of observation group were more than those of control group,and the dosage of Ephedrine and Phenylephrine were less than those of control group,the differences were statistically significant(P<0.05).At the end of the surgery,the levels of Lac,VO2I,DO2I were superior than those of induction time of both groups,and Lac(0.82±0.39)mmol/L of observation group was lower than(2.25±0.61)mmol/L of control group,VO2I(153.76±8.49)mL/(min·m^(2)),DO2I(572.82±13.26)mL/(min·m^(2))were higher than(124.76±7.51)mL/(min·m^(2))of control group,(542.54±25.54)mL/(min·m^(2))(P<0.05).The incidence of complications of observation group was 4.65%,lower than 23.26%of control group,the difference was statistically significant(P<0.05).Conclusion:Combined cardiopulmonary ultrasound monitoring for patients undergoing thoracoscopic lobectomy has a high application value,which can reduce the amount of intraoperative vasoactive drugs,improve the balance of oxygen supply and demand,and reduce the incidence of complications.

关 键 词：胸腔镜下肺叶切除术 心肺联合超声 液体管理 

分 类 号：R655.3[医药卫生—外科学]