基于FloTrac/Vigileo监测下手术体位改变对患者心指数及每搏变异度的影响

Effect of operation position change on heart index and stroke volume variation in patients monitored by FloTrac/Vigileo system

目的探讨FloTrac/Vigileo监测下不同的手术体位对患者心指数(CI)及每搏变异度(SVV)的影响,为患者血流动力学管理和液体治疗提供参考依据。方法择期行电视辅助胸腔镜食管癌根治术患者60例,使用FloTrac/Vigileo系统观察患者CI及SVV的变化,记录麻醉诱导后5min(T0)、改头低脚高位5min(T1)、改头高脚低位5min(T2)患者的CI、SVV及中心静脉压(CVP)。结果与T0时点比较,T1时点和T2时点患者CI下降(P<0.05);与T0时比较,T1时患者SVV下降,CVP升高,T2时SVV升高,CVP降低(P<0.05)。结论手术体位改变会对患者的CI、SVV及CVP造成显著影响,关注相应改变可为术中血流动力学管理和液体治疗提供参考依据。

Objective To investigate the effect of different operation positions on cardiac index （CI） and stroke volume varia- tion （SVV） in the patients monitored by FloTrac/Vigileo system to provide some references for the hemodynamic management and liquid treatment of the patients. Methods Sixty patients scheduled for elective TV auxiliary thoracoscope radical operation of e- sophageal cancer. The CI and SVV changes were observed by using the FloTrac/Vigileo system. CI,SVV and CVP were recorded at 5 min after anesthesia induction （T0）, 5 min after converting to the position of head low feet high （T1）, 5 min after converting to the position of head high feet low （T2）. Results Compared with To ,CI at T1 and T2 was decreased（P〈0.05） ;compared with To, SVV at T1 was decreased and CVP was increased;SVV at T2 was increased and CVP was decreased（P〈0.05）. Conclusion The operation position change may have a significant impact on the patientrs CI, SVV and CVP. Focusing on the corresponding change can provide some references for the intraoperative hemodynamic management and liquid treatment.