胸阻抗法无创血流动力学监测指标与前列腺电切患者术中液体反应性的关系研究  

Study on the relationship between non-invasive hemodynamic monitoring indexes by thoracic impedance method and intraoperative fluid reactivity in patients with electro-prostatectomy

作　　者：蔡慧茹 支连军 CAI Huiru;ZHI Lianjun(Department of Anesthesiology,Suqian Hospital of Traditional Chinese Medicine,Suqian,Jiangsu,223800,China)

机构地区：[1]宿迁市中医院麻醉科,江苏宿迁223800

出　　处：《当代医学》2024年第9期43-47,共5页Contemporary Medicine

摘　　要：目的分析胸阻抗法无创血流动力学监测指标与前列腺电切患者术中液体反应性的关系。方法选取2019年1月至2021年12月宿迁市中医院收治的80例前列腺增生患者作为研究对象,均行前列腺电切术;以每搏量指数变化百分比(△SVI)≥10%作为判定患者术中具有液体反应性的依据,根据术中输液是否具有液体反应性分为有反应组(n=76)与无反应组(n=52)。所有患者均在输液前进行胸阻抗法无创血流动力学监测,比较两组心排血量(CO)、心排指数(CI)、每搏心排血量(SV)、每搏心脏做功(SW)、心脏每分做功(CW)、左室舒张末压(LVEDP)、心率(HR),采用多因素Logistic回归分析无液体反应性的独立预测因素,分析胸阻抗法无创血流动力学监测指标与△SVI的相关性,通过绘制ROC计算AUC,评估胸阻抗法无创血流动力学监测指标对无液体反应性的预测效能。结果有反应组SV、SW、CW均高于无反应组,差异有统计学意义(P<0.05);两组CO、CI、LVEDP、HR比较差异无统计学意义;多因素Logistic回归分析结果显示,SV、SW和CW均是前列腺电切患者术中对输液无反应性的独立预测因素(P<0.05);经Pearson相关性分析,前列腺电切患者SV、SW和CW均与△SVI呈正相关(P<0.05);经ROC曲线分析,SV、SW联合CW预测前列腺电切患者术中对输液无反应性的AUC大于单一指标SV、SW和CW的AUC结果(P<0.05)。结论胸阻抗法检测SV、SW联合CW能有效预测前列腺电切患者术中液体反应性,对于指导术中液体治疗具有积极作用,值得临床进一步研究应用。Objective To analyze the relationship between non-invasive hemodynamic monitoring indexes by thoracic impedance method and in-traoperative fluid reactivity in patients with electro-prostatectomy.Methods A total of 80 patients with prostatic hyperplasia treated in Suqian Hospi-tal of Traditional Chinese Medicine from January 2019 to December 2021 were selected as the study subjects,all of whom underwent electroprosta-tectomy.The percentage change of stroke volume index(△SVI)≥10%was used as the basis to determine the intraoperative fluid reactivity of pa-tients.According to the intraoperative fluid reactivity,patients were divided into the response group(n=76)and the non-response group(n=52).All patients underwent non-invasive hemodynamic monitoring by thoracic impedance method before infusion,the cardiac output(CO)and cardiac out-put index(CI),stroke output(SV),stroke work(SW),cardiac work(CW),left ventricular end-diastolic pressure(LVEDP),heart rate(HR)were com-pared between the two groups,multivariate Logistic regression was used to analyze independent predictors of non-fluid reactivity,and the correlation between thoracic impedance non-invasive hemodynamic monitoring indexes and△SVI was analyzed.The ROC AUC was used to evaluate the effica-cy of non-invasive hemodynamic monitoring indicators of the thoracic impedance method in predicting non-fluid reactivity.Results The SV,SW and CW in the response group were higher than those in the non-response group,the difference was statistically significant(P<0.05);there was no signifi-cant difference in CO,CI,LVEDP and HR between the two groups.The results of multivariate Logistic regression analysis showed that SV,SW and CW were independent predictors of intraoperative non-reactivity of electro-prostatectomy(P<0.05).By Pearson correlation analysis,SV,SW and CW were positively correlated with△SVI(P<0.05).According to ROC curve analysis,the AUC of SV,SW combined with CW in predicting the non-re-sponsiveness to infusion in patients undergoing transurethral resection

关 键 词：前列腺增生 前列腺电切 胸阻抗法 无创血流动力学 液体反应性 

分 类 号：R697.32[医药卫生—泌尿科学]