食道超声多普勒监测仪在OPCAB中的使用

The utility of esophageal Doppler monitor during off-pump coronary bypass surgery

目的评价非体外循环冠脉搭桥手术中食道超声多普勒监测仪的使用价值。方法20例冠脉多支病变病人行非体外循环冠脉搭桥手术时采用食道超声监测仪监测,观察在心包切开前、吻合左前降支,吻合后降支和钝缘支时的血流动力学变化。结果病人在吻合左前降支,后降支和钝缘支时都出现了心输出量、每搏量、降主动脉血流峰值和加速度的显著下降;心率在各个吻合阶段都没有出现显著改变。平均动脉压和纠正左室射血时间只有在钝缘支吻合阶段才出现显著下降;而外周血管阻力在吻合各阶段都出现了显著升高。结论食道超声监测仪可以用于监测非体外循环冠脉搭桥中血流动力学的改变。

Objective To evaluta hemodynamic change with esophageal Doppler monitor during off-pump coronary bypass. Methods Esophageal Doppler monitor was inserted in twenty patients and hemodynamic data were obtained before pericardial incision, during left anterior descending artery (LAD) grafting, during posterior descending artery (PDA) grafting and during obtuse marginal (OM) grafting. Results All the patients completed the surgery without cardiopulmonary bypass successfully. Cardiac output, stroke volume, peak velocity and acceleration of blood flow in the descending aorta declined significantly during LAD,PDA and OM grafting. Heart rate didn't show any significant change during the whole period; However, systemic vascular resistance increased comparing with the baseline. Conclusion Esophageal Doppler monitor can used in the off-pump coronary bypass surgery.