Flotrac监测在心功能不全患者麻醉中的应用

Application of the Flotrac monitoring in an anesthesia for patients with cardiac insufficiency

目的探讨Flotrac监测在心功能不全患者麻醉中的应用价值。方法随机选择心功能不全预备手术的患者100例作为研究对象,按照双盲信封法分为对照组与观察组,各50例,2组均进行常规麻醉处理,对照组予MAP、CVP监测,观察组予Flotrac监测,观察2组LVEF变化和内皮功能,不同时间点HR、MAP、CVP水平,心功能水平。结果术后2 h观察组LVEF水平明显高于对照组(P<0.05),但术后2 h 2组FMD水平无明显差异(P>0.05);2组经麻醉诱导后时CVP、MAP及HR水平显著下降,观察组CVP及MAP水平较对照组恢复较快,至手术开始时CVP、MAP、HR水平接近正常数值,差异具有统计学意义(P<0.05);术后2 h观察组各项指标均显著高于对照组(P<0.05)。结论Flotrac监测在心功能不全患者麻醉中具有理想的应用价值,可显著提高患者LVEF水平及心功能指标,保证患者在手术过程中获得稳定的血流动力学。

Objective To explore the application value of the Flotrac monitoring for patients with cardiac insufficiency under an anesthesia.Methods A total of 100 preoperative patients with cardiac insufficiency were randomly selected as the research subjects and divided into a control group and an observation group by the double-blind envelope method,with 50 cases in each group.The control group was monitored by MAP and CVP,and the observation group was monitored by Flotrac while the two groups were both put under a routine anesthesia.The changes of the LVEF level and the endothelial function,the HR,MAP,CVP levels at different time points,and the cardiac function level in the two groups were observed.Results The level of LVEF in the observation group was significantly higher than that in the control group 2 hours after operation(P<0.05),but there was no significant difference in the level of FMD(P>0.05).After an anesthesia induction,the levels of CVP,MAP and HR in both groups were significantly decreased,and the levels of CVP and MAP in the observation group recovered faster than those in the control group,and were close to normal values at the beginning of surgery,with a statistical significance(P<0.05).All the indexes in the observation group were significantly higher than those in the control group 2 hours after operation(P<0.05).Conclusion The Flotrac monitoring has an ideal application value for patients with cardiac insufficiency under an anesthesia.It can significantly improve the patients’LVEF level and cardiac function indexes,and ensure patients can obtain a stable hemodynamics during surgery.