围手术期超声对全身麻醉患者容量反应性的评估作用  

Perioperative ultrasound in the evaluation of fluid responsiveness in patients under general anesthesia

作　　者：栗亚茹 姜陆洋[1] 冯艺[1] 王璐[1] 窦豆 Li Yaru;Jiang Luyang;Feng Yi;Wang Lu;Dou Dou(Department of Anesthesiology,People's Hospital of Peking University,Beijing 100044,China)

机构地区：[1]北京大学人民医院麻醉科,100044

出　　处：《国际麻醉学与复苏杂志》2021年第9期966-972,共7页International Journal of Anesthesiology and Resuscitation

摘　　要：容量反应性被定义为患者在10~15 min接受500 ml晶体溶液后,每搏量(stroke volume,SV)增加10%~15%。床旁超声技术在手术室内的广泛应用使得利用超声进行容量评估成为可能。经胸超声心动图(transthoracic echocardiography,TTE)检查是无创操作,经食管超声心动图检查(trans-esophageal echocardiography,TEE)是微创操作,TEE在围手术期可以动态、实时、连续监测容量,并且图像质量稳定良好。文章对预测容量反应性的超声指标分类(呼吸-脉搏参数、静脉呼吸变异度、舒张功能相关参数、容量反应性试验)进行综述,以期提供较为全面的认识。Fluid responsiveness is defined as an increase in stroke volume by 10%to 15%after infusion of 500 ml crystalloid over 10 min to 15 min.The wide application of point-of-care ultrasound in the operating room makes it possible to evaluate fluid responsiveness by ultrasound.Transthoracic echocardiography(TTE)examination is noninvasive,while trans-esophageal echocardiography(TEE)is minimally invasive.During the perioperative period,TEE can monitor fluid responsiveness in a dynamical,real-time,and continuous manner,with stable quality of images.The review is to summarize the ultrasound indicators that can predict fluid responsiveness,including respiratory-pulse parameters,respiratory variation of the vein,parameters related to cardiac diastole function,and fluid responsiveness tests,so as to provide comprehensive understanding.

关 键 词：容量反应性 经食管超声心动图检查 静脉呼吸变异度 每搏量变异度 

分 类 号：R614[医药卫生—麻醉学]