连续有创动脉血压监测联合TEE在心脏病患者非心脏手术麻醉期间的应用效果  

Application Effect of Continuous Invasive Arterial Blood Pressure Monitoring Combined with TEE in Patients with Cardiac Disease During Non-Cardiac Surgery Anesthesia

作　　者：查卫峰 顾顺 谢佳亮 ZHA Weifeng;GU Shun;XIE Jialiang(Department of Anesthesiology,Lianshui County People's Hospital,Huaian 223400,China)

机构地区：[1]涟水县人民医院麻醉科,淮安223400

出　　处：《中国医药指南》2024年第22期45-47,共3页Guide of China Medicine

摘　　要：目的探讨连续有创动脉血压监测联合经食管超声心动图(TEE)在心脏病患者非心脏手术麻醉期间的应用效果。方法回顾性分析2020年1月至2022年12月我院收治的60例心脏病患者的临床资料。患者均开展非心脏手术,并应用连续有创动脉血压监测联合TEE。分析患者术中的血压水平和气管插管后即刻(T1)、3 min(T2)、10 min(T3)、30 min(T4)的心率(HR)、左心室收缩末期容积(LVESV)、左心室舒张末期容积(LVEDV)、左心室射血分数(EF)、每搏输出量(SV)、心输出量(CO)水平。结果60例心脏病患者在开展非心脏手术过程中,28例患者在麻醉过程中生命体征平稳,且血压波动水平未超过基础值的10%;32例患者血压波动水平超过基础值的10%,其中有26例患者在2 min内得到有效处理,5例患者在2~3 min得到有效处理,余1例患者则在3~4 min内得到处理,且有31例患者在5 min内血压水平恢复至目标范围内,1例患者在10 min内恢复至目标范围内;T2、T3、T4时刻的HR、LVEDV、LVESV、SV、EF、CO水平均高于T1时刻。结论连续有创动脉血压监测联合TEE在心脏病患者非心脏手术术中具有较高的应价值,能有效监测患者血压水平和麻醉诱导时及麻醉过程中心功能变化情况,为指导医师在手术过程中采取有效措施来维持患者循环和心功能水平保持稳定提供可靠依据,在保证患者术中生命安全具有积极意义。Objective To investigate the application effect of continuous invasive arterial blood pressure monitoring combined with transesophageal echocardiography(TEE)in patients with cardiac disease during non-cardiac surgery anesthesia.Methods The clinical data of 60 patients with heart disease admitted to our hospital from January 2020 to December 2022 were retrospectively analyzed.All patients underwent non-cardiac surgery and continuous invasive arterial blood pressure monitoring combined with TEE was used.The intraoperative blood pressure level and heart rate(HR),left ventricular end-systolic volume(LVESV),left ventricular end-diastolic volume(LVEDV),left ventricular ejection fraction(EF),stroke volume(SV)and cardiac output(CO)obtained in the patients at the moment of tracheal intubation(T1),3 min(T2),10 min(T3),and 30 min(T4)were analysed.Results In 60 patients with heart disease during non-cardiac surgery,28 patients had stable vital signs during anesthesia,and the fluctuation level of blood pressure did not exceed 10%of the basic value;The blood pressure fluctuation level of 32 patients exceeded 10%of the basic value,among which 26 patients were effectively treated within 2 min,5 patients were effectively treated within 2-3 min,the remaining 1 patient was effectively treated within 3-4 min,and the blood pressure level of 31 patients recovered to the target range within 5 min.1 patient recovered to the target range within 10 min;The levels of HR,LVEDV,LVESV,SV,EF and CO at T2,T3 and T4 were higher than those at T1.Conclusions Continuous invasive arterial blood pressure monitoring combined TEE has a high value in non-cardiac surgery for patients with heart disease.It can effectively monitor the blood pressure level of patients and the changes in the function of the center during anesthesia induction and anesthesia process,and provide a reliable basis for guiding physicians to take effective measures to maintain the circulation and cardiac function level of patients during surgery.It has positive significance in ensu

关 键 词：经食管超声心动图 连续有创动脉血压监测 心脏病 麻醉 

分 类 号：R54[医药卫生—心血管疾病] R614[医药卫生—内科学]