每搏连续无创血压监测系统在心脏瓣膜术后低心排血量综合征监护中的应用  

Application of Continuous Noninvasive Arterial Pressure Monitoring System in Monitoring Low Cardiac Output Syndrome after Cardiac Valve Surgery

作　　者：杨超 林君卿 翁晓丽[1] 任宇虹 李春平[1] 薛贻敏[1] 郑永红[1] YANG Chao;LIN Junqing;WENG Xiaoli;REN Yuhong;LI Chunping;XUE Yimin;ZHENG Yonghong(Fujian Provincial Clinical College,Fujian Medical University,Fuzhou 350001,China)

机构地区：[1]福建医科大学省立临床医学院(福建省立医院),福建福州350001

出　　处：《中国医学创新》2023年第9期49-53,共5页Medical Innovation of China

基　　金：福建省重症医学中心建设项目(2017-510);福建省自然科学基金面上项目(2017J01252);福建医科大学启航基金(2020QH1149)。

摘　　要：目的:探讨每搏连续无创血压(continuous noninvasive arterial pressure,CNAP)监测系统在心脏瓣膜术后低心排血量综合征(low cardiac output syndrome,LCOS)监测中的应用价值。方法:选取福建省立医院2020年4月-2022年4月心脏瓣膜术后合并LCOS患者76例。随机将其分为对照组(n=44)和CNAP组(n=32)。对照组给予常规治疗,CNAP组给予CNAP指导治疗。比较两组瑞芬太尼、丙泊酚、多巴酚丁胺和去甲肾上腺素总用量,ICU住院时间,有创机械通气时间,液体平衡总量。结果:两组瑞芬太尼、丙泊酚总用量、ICU住院时间、有创机械通气时间比较,差异均无统计学意义(P>0.05)。CNAP组多巴酚丁胺总用量、去甲肾上腺素总用量、液体平衡总量均小于对照组,差异均有统计学意义(P<0.05)。结论:应用CNAP指导心脏瓣膜术后LCOS患者的治疗能够优化此类患者术后的血流动力学管理。Objective:To investigate the value of continuous noninvasive arterial pressure(CNAP)monitoring system in monitoring low cardiac output syndrome(LCOS)after heart valve surgery.Method:The clinical data of 76 patients with combined LCOS after heart valve surgery in Fujian Provincial Hospital from April 2020 to April 2022 were analyzed.The patients were randomly divided into control group(n=44)and CNAP group(n=32).The control group was treated with conventional treatment,CNAP group was treated with CNAP-guided therapy.The total amount of Remifentanil,Propofol,Dobutamine and Norepinephrine,ICU length of stay,invasive mechanical ventilation time and total fluid balance were compared between the two groups.Result:There were no significant differences in the total dosage of Remifentanil and Propofol,length of ICU stay and invasive mechanical ventilation time between the two groups(P>0.05).Total dosage of Dobutamine,total dosage of Norepinephrine and total fluid balance in CNAP group were lower than those in control group,with statistical significances(P<0.05).Conclusion:The application of CNAP to guide the treatment of patients with LCOS after heart valve surgery can optimize the postoperative hemodynamic management of these patients.

关 键 词：每搏连续无创血压监测系统 低心排血量综合征 心脏瓣膜手术 

分 类 号：R654.2[医药卫生—外科学]