脑血管手术机械通气患者灌注变异指数与CVP和MAP的相关性研究

The correlation of pleth variability index with CVP and MAP in mechanically ventilated patients undergoing cerebral vessels operation

目的研究脑血管手术机械通气患者灌注变异指数(PVI)与CVP和MAP的相关性。方法脑血管手术患者15例,术中均需自体血回输,术前30 min内输注6%羟乙基淀粉130/0.4(HES)500 ml,术中输注复方氯化钠10 ml.kg-1.h-1。机械通气采用容量控制模式,潮气量8ml/kg,保持气道压在18 cm H2O左右。记录诱导前(T0)、诱导后(T1)、输注HES后(T2)、自体血回输前(T3)、自体血回输后(T4)的PVI、CVP和MAP。结果 PVI的变化与CVP、MAP的变化呈负相关,相关系数分别为-0.82(P<0.05)和-0.73(P<0.05)。结论 PVI可以作为脑血管手术机械通气患者血流动力学变化的有效判断指标,其与CVP和MAP呈负相关。

Objective To investigate the correlation of PVI with CVP and MAP in mechanically ventilated patients undergoing cerebral vessels operation. Methods Fifteen patients undergoing cerebral vessels operation with autoblood transfusion were enrolled. Besides infusing 500 ml of 6% hetastarch before operation, ringer＇s solution was infused continously（10 ml · kg-1 · h-1） during operation. The patients were intuhated and mechnically ventilated in volume controll（VT =8 ml/kg, airway pressure was kept at 18 crn H20）. PVI, CVP and MAP were recorded before anesthesia （T0）, after induction （T1）, after volume expansion （500 ml of 6% hetastarch） （T2）, before （T3） and after （T4） autoblood transfusion. Results The correlative coefficient between PVI and CVP, PVI and MAP were - 0. 82 （P〈0. 05） and -0.73 （P〈0. 05） respectively. Conclusion PVI was a sensitive index to judge change of haemodynarnics in mechanically ventilated patients. The correlations between PVI and CVP, and PVI and MAP were negative.