Flotrac/Vigileo监测体位对腹腔镜肾脏切除术患者血流动力学的影响

The effect of the different position on hemodynamic monitored by Flotrac/Vigileo system in patients undergoing laparoscopic radical nephrectomy

目的:探讨应用Flotrac/Vigileo监测不同体位下腹腔镜肾脏切除术患者血流动力学的影响。方法:腹腔镜肾脏切除术患者40例，ASA分级I~11级，随机分成两组，每组20例，A组体位为侧卧位，B组为俯卧位。Flotrac/Vigileo系统监测患者血流动力学变化。麻醉诱导后分别记录插管后气腹前(T。），改变体位后（),气腹后5min(T2),30min(T3),气腹结束后1min(T4)及恢复体位时（T5)的HR、MAP、心输出量（CO)、心脏指数（Cl)及每搏量（SV)。结果:与T。时相比，B组的C0、CI及SV在时降低;与T1时相比,A,B两组的各项监测指标在^、^时均增高；与A组相比,B组的C0、CI、SV在T1-T4各时间点均降低。结论:俯卧位下行腹腔镜肾脏切除术,患者的血流动力学虽有变化，但在临床许可范围内；Flotrac/Vigileo系统可实时监测腹腔镜肾脏切除术患者的血流动力学。

Objective To investigate the effect of the different position on hemodynamic monitored by Flotrac/Vigileo system inpatients undergoing laparoscopic radical nephrectomy. Method Forty patients undergoing laparoscopic radical nephrectomy surgery,ASA I ?II,were randomly divided into two groups (n = 20) ’position for the A group B group of lateral position,prone position* Thehemodynamic changes were monitored by Flotrac/Vigileo system. HR-,MAP-,cardiac output( CO) ^cardiac index( Cl) and stroke volume(SV) were recorded before pneumoperitoneum (T0) ,after changed the position(T! ) ,5 min after pneumoperitoneum(T2) ,30min after pneumoperitoneum(T3 ) ,1 min after the end of pneumoperitoneum( T4 ) and after the end of position(T5) after inductionof anesthesia. Results Compared with T0,CO、Cl and SV of group B decreased at ; Compared with , all monitoring index ofgroup A and group B increased at T2 and T3 ;Compared with group A,C0 ~,CI and SV of group B decreased significantly at Tl ?T4. Conclusion The hemodynamics despite changes in clinical, but permitted during prone position in laparoscopic nephrectomy.The hemodynamic of laparoscopic radical nephrectomy patients can be monitored real - time by Flotrac/Vigileo.