动脉收缩压上升速率评价心肌收缩能力

EVALUATION OF CARDIAC CONTRACTILIIY WITH ASCENDANT SPEED OF ARTERY SYSTOLIC PRESSURE

用动脉收缩压最大上升速率（ｄｐ／ｄｔｍａｘ）和平均上升速率（ｄｐ／ｄｔｍｅａｎ）评价心肌收缩能力。结果显示：硬膜外麻醉下，腹腔探查时，ＭＡＰ，ＨＲ，ＣＯ，ＲＴｍ，ｄｐ／ｄｔｍａｘ和ｄｐ／ｄｔｍｅａｎ均明显下降（Ｐ＜０．０５），而在中小剂量芬太尼复合麻醉下，术前ｄｐ／ｄｔｍａｘ和ｄｐ／ｄｔｍｅａｎ明显下降（Ｐ＜０．０５），ＭＡＰ，ＳＶ，ｃｏ，ＲＴｍ无明显变化（Ｐ＞０．０５）。表明麻醉药对心肌收缩能力有抑制作用；动脉收缩压ｄｐ／ｄｔｍａｘ和ｄｐ／ｄｔｍｅａｎ能反映心肌收缩能力的变化，是临床评价心肌收缩能力简单、敏感、可靠的指标。

valuation of cardiac contractility with ascendant speed(dp/dt max and dp/dt mean)ofartery systolic pressure was studied.Thirty patients for upper abdominal surgery were randomlyallocated to one of the three groups:epidural anesthesia(T_(3-4)～T_(2-3) levels),loW dose of fen-tanyl(10μg/kg)anesthesia and medium dose of fentanyl(20～30μg/kg)anesthesia.In epiduralgroup,MAP,CO,HR,RTm,dp/dt max and dp/dt mean decresased significantly at check-upfor abdominal cavity(P< 0.05).In fentanyl groups,dp/dt max and dp/dt mean decreasedsignificantly(P<0.05),but MAP, HR, SV,CO and RTm did not change(P >0.05)beforeoperation.The result showed that the ascendant speed of artery systolic pressure could reflex thechange of cardiac contractility