预扩容对肺手术患者麻醉诱导期血流动力学影响的临床研究

Clinical research of influence of preliminary expansion to hemodynamics of patients treated with lung surgery at anesthesia induction period

目的研究分析预扩容对肺手术患者麻醉诱导期血流动力学的影响。方法选取入院治疗的肺气肿患者36例、肺癌患者22例,将其随机分为实验组(29例)和对照组(59例),实验组患者在麻醉前应用乳酸钠林格或羟乙基淀粉,对照组麻醉术前不做任何措施。观察两组患者麻醉诱导期的血流动力学变化。结果实验组患者预扩容前后有明显对比,且与对照组在SBP、Hb、CO、SVR、TFC方面的对比具有显著性差异。麻醉后开始,除了麻醉后5 min,在HR方面两组没有差异,在不同时间段内实验组与对照在MAP、HR、CVP方面均具有显著性差异。上述数据均具有统计学意义。结论预扩容对于肺部手术患者具有维持循环稳定、降低外周阻力及低血压的发生率、提高了患者对失血的耐受性、优化了血液流变状态,对肺部手术的操作具有安全、易行的积极作用。

Objective To analyze the influence of preliminary expansion to hemodynamics of patients treated with lung surgery at anesthesia induction period.Methods 36 patients with pulmonary emphysema and 22 patients with lung cancer were randomly divided into the experiment group（29 cases） and the control group（59 cases）.Before anesthesia,the control group didn＇t receive any measures,and the experiment group was given used sodium lactate or hydroxyethyl starch.The hemodynamic changes were observed and compared between the two groups.Results There were obvious differences on SBP,Hb,CO,SVR,and TFC between the two groups after preliminary expansion.There was no significant difference on HR 5 minutes after anesthesia between the two groups.Conclusion Preliminary expansion can keep circulation stable,reduce the peripheral resistance and the incidence of low blood pressure,improve their tolerance to blood loss,and optimize the blood rheological state to patients treated with lung surgery.