门静脉高压患者TIPSS手术前后的氧动力学监测

OXYGEN DYNAMICS PRE-AND POST-TIPSS IN PATIENTS WITH PORTAL HYPERTENSION

目的 观察门静脉高压症患者行 TIPSS手术后氧供、氧耗的变化 ,探讨 TIPSS对机体氧动力学的影响。方法 14例门脉高压患者行 TIPSS治疗 ,分别于术前、术后 30分钟和术后 2周经右颈内静脉置入 Swan- Ganz导管监测血流动力学和氧供、氧耗、氧摄取率。结果 TIPSS术后患者心脏指数明显增加 ,氧供明显增加 ,但氧耗无显著变化。结论 TIPSS手术加重心脏负担 ,增加氧供 ,但机体通过代偿机制能够维持正常氧耗。手术后监测氧动力学具有重要指导意义。

Objective To observe the changes of oxygen delivery and consumption in patients with portal hypertention pre-and post-transjugular intrahepatic portosystemic stent shunt(TIPSS),and to evaluate the effects of TIPSS on oxygen dynamics.Methods Swan-Ganz catheters were inserted in 14 patients with portal hypertension and undergoing TIPSS.Hemodynamics and oxygen dynamics were monitored preoperation,30 minutes and 2 weeks after operation.Results A significant increase was found in cardiac index and oxygen delivery after TIPSS.There was no significant change in oxygen consumption after operation.Conclusion TIPSS may increase the preload of the heart,and elevate oxygen delivery.Oxygen consumption is maintained in normal range by the compensatory mechanisms of the body.Monitoring of hemodynamics oxygen dynamics is of significance in clinical practice.