冠状动脉旁路移植术围术期血流动力学变化

Change of hemodynamics in patients during perioperative of coronary artery bypass grafting

目的观察冠状动脉旁路移植术围术期血流动力学各项指标变化,了解患者心功能、血容量变化规律,以期指导临床治疗。方法选择20例行冠状动脉旁路移植术患者,监测病人心率、血压、中心静脉压,用热稀释法连续测量心排血量,心排血指数等指标。结果全部患者均存活,术后12￣24h内存在心排血量,心排血指数减低,体循环阻力升高现象。搭1、2支桥的病人术后心排血指数上升较快,心功能恢复好;搭3、4支桥的病人心排血指数上升较慢,心功能受影响大。结论各项血流动力学指标能及时反映心功能、血容量变化,对术后低心排血量综合征的防治起指导作用。

[Objective] To observe the changes of all indexes of hemodynamies in patients during perioperative of coronary artery bypass grafting, and to find out the patients＇ regular pattern of the change of cardiac output and cardiac index to direct the clinical treatment. [Methods] Twenty patients receiving coronary artery bypass grafting were selected and their parameters of heart rate, mean arterial blood pressure, central venous pressure were monitored, and the cardiac output and cardiac index were continually measured with thermodilution method. [Results] All patients survived, but had low cardiac output and cardiac index and high systemic vascular resistance during postoperative 12 to 24 hours. The postoperative cardiac index of the patients who were transplanted 1-2 bridges rose fast and the cardiac function recovered well, yet the cardiac index of the patients who were transplanted 3-4 bridges rose sIow and the cardiac function was influenced largely. [Conclusion] All parameters of hemodynamies can reflect the changes of cardiac function and blood capacity promptly. It can guide the treatments of postoperative low cardiac output syndrome.