应用去氧肾上腺素后脉搏压变异度和每搏量变异度相关性研究

The correlation between pulse pressure variation and stroke volume variation after using phenylephrine

目的探讨应用去氧肾上腺素后脉搏压变异度(PPV)和每搏量变异度(SVV)的相关性。方法选择肝胆外科择期肝脏切除手术患者20例,全麻诱导后循环稳定时,记录心率(HR)、动脉收缩压(SAP)、心输出量(CO)、心输出量指数(CI)、每搏量(SV)、每搏量指数(SVI)、PPV和SVV,改变去氧肾上腺素泵入速度使SAP分别提高10%<ΔSAP≤20%、20%<ΔSAP≤30%和30%<ΔSAP≤40%并记录上述参数,对各个压力阶段的PPV和SVV进行相关性分析。结果去氧肾上腺素降低PPV和SVV值,各压力水平的PPV和SVV的数值具有高度相关性:T1,r=0.935,P<0.01;T2,r=0.947,P<0.01;T3,r=0.971,P<0.01;T4,r=0.973,P<0.01。结论虽然去氧肾上腺素高估了容量状态,但是脉搏压变异度(PPV)和每搏量变异度(SVV)在应用去氧肾上腺素后依然具有高度相关性。

Objective To evaluate the correlation between the pulse pressure variation（PPV）and stroke volume variation（SVV）after using phenylephrine. Methods Twenty patients underwent liver partial resection with ASA I^II were selected to this study. After anesthesia induction and the circulation state became stable, HR, SAP, CO, CI, SV, SVI,PPV and SVV were recorded（T1）. Changing the phenylephrine injection speed to make the SAP increase：10% ΔSAP ≤20%（T2）, 20%ΔSAP≤30%（T3）, 30%ΔSAP≤40%（T4）and calculate the correlation coefficient（r）of every SAP level.Results Phenylephrine decreased the PPV and SVV value,there was a significant correlation between PPV and SVV at four SAP levels according to the linear regression analysis：T1, r = 0.935, P〈 0.01; T2, r = 0.947, P〈 0.01; T3, r = 0.971,P〈 0.01; T4, r = 0.973, P〈 0.01. Conclusion Phenylephrine can mis-interpret and overestimate patients＇ volume state,but PPV and SVV are well correlated when using it.