不同体位及气腹压下脉搏灌注变异指数与每搏量变异度的相关性分析  

Correlation analysis between pleth variability index and stroke volume variation under different body postures and pneumoperitoneum pressures

作　　者：吕晓敏 赵智慧 Lv Xiaomin;Zhao Zhihui(Department of Operation and Anesthesiology,People's Hospital of Inner Mongolia Autonomous Regional,Huhhot 010017,China)

机构地区：[1]内蒙古自治区人民医院手术麻醉科,呼和浩特010017

出　　处：《北京医学》2024年第5期410-414,共5页Beijing Medical Journal

基　　金：内蒙古自治区自然科学基金(2019MS08091)。

摘　　要：目的探讨不同体位、气腹压下脉搏灌注变异指数(pleth variability index,PVI)与每搏量变异度(stroke volume variation,SVV)的相关性。方法选取2022年6—12月内蒙古自治区人民医院择期行腹腔镜右半结肠癌根治术的患者60例,全麻后依次在水平位(T1)、Trendelenburg位(T2)、Trendelenburg左倾45°位(T3)3种体位下监测患者HR、MAP、PVI及SVV的变化,并分析不同体位下PVI与SVV的相关性。手术前根据不同气腹压将患者分为A组(10 mmHg)、B组(12 mmHg)和C组(14 mmHg)(1 mmHg=0.133 kPa),每组20例,监测3组不同体位下HR、MAP、PVI及SVV的变化,并分析不同气腹压下PVI与SVV的相关性。结果60例患者中男32例、女28例,平均年龄(53.1±7.7)岁。气腹前,与T1时相比,T2、T3时的HR较低,差异有统计学意义(P<0.05);3种体位下PVI与SVV均存在线性正相关(P<0.05)。气腹后3种体位下,与A组相比,B组、C组的MAP、PVI、SVV均较高;与B组相比,C组HR较低、MAP较高,差异均有统计学意义(P<0.05)。气腹后3种体位下,A组PVI与SVV均呈线性正相关(P<0.05)。结论无气腹状态下,不同体位下PVI与SVV均呈线性正相关。低气腹压(10 mmHg)下,不同体位时PVI与SVV呈线性正相关。体位虽不影响PVI与SVV的正相关性,但超过10 mmHg的气腹压会影响二者的正相关性。Objective To explore the correlation between pleth variability index(PVI)and stroke volume variability(SVV)under different body postures and pneumoperitoneum pressures.Methods A total of 60 patients underwent laparoscopic radical resection of right colon cancer in People's Hospital of Inner Mongolia Autonomous Region from June to December 2022 were selected.After general anesthesia,the changes of HR,MAP,PVI and SVV were monitored in three body postures in turn,namely horizontal posture(T1),Trendelenburg(T2)and Trendelenburg left tilt 45°posture(T3),and the correlation between PVI and SVV under different postures were analyzed.Before operation,the patients were divided into group A(10 mmHg),group B(12 mmHg)and group C(14 mmHg)(1 mmHg=0.133 kPa)according to different pneumoperitoneum pressures,with 20 cases in each group.The changes of HR,MAP,PVI and SVV in three groups under different body postures were monitored,and the correlation between PVI and SVV under different pneumoperitoneum pressures were analyzed.Results Among the 60 patients,there were 32 males and 28 females,with an average age of(53.1±7.7)years.Compared with T1 before pneumoperitoneum,HR at T2 and T3 was lower,the difference was statistically significant(P<0.05),and there was a linear positive correlation between PVI and SVV at the three postures(P<0.05).Under three postures after pneumoperitoneum,compared with group A,the MAP,PVI and SVV in group B and group C were higher,while HR was lower and MAP was higher in group C compared with group B,and the differences were statistically significant(P<0.05).There was a linear positive correlation between PVI and SVV in group A under three different postures after pneumoperitoneum(P<0.05).Conclusions In the absence of pneumoperitoneum,PVI and SVV are linearly positively correlated in different postures.After pneumoperitoneum,there is a linear positive correlation between PVI and SVV at a lower pneumoperitoneum pressure(10 mmHg)at different postures.Body position does not affect the positive correlation be

关 键 词：脉搏灌注变异指数 每搏量变异度 气腹压 水平位 Trendelenburg位 Trendelenburg左倾45°位 

分 类 号：R614[医药卫生—麻醉学]