Objective： To observe the cardiac output （CO） in animals and patients undergone valve replacement with Jiuling bileaflet mechanical valve prosthesis. Methods： 1. Animal experiments： 6 sheep that subjected to mitr...Objective： To observe the cardiac output （CO） in animals and patients undergone valve replacement with Jiuling bileaflet mechanical valve prosthesis. Methods： 1. Animal experiments： 6 sheep that subjected to mitral replacement with a 2 I-ram-valve prosthesis were measured by open cardiac catheterization intraoperatively. Echocardiographic and open cardiac catheterization under dobutamine stress were performed on 2 sheep survival for 30 months post-operation.2. Patient measurements： CO of 14 cases of aortic valve and 10 cases of mitral valve was measured by open cardiac catheterization,and after 12 months,it was measured by echocardiography. Results： 1. Animal experiments： The mean CO of 6 sheep was 2.5 L/min intraoperatively by catheterization, and that of 2 sheep survival for 30 months post-implant was 3.0 L/min by echocardiography and 2.9 L/min by catheterization, respectively. 2. Patient measurements： The mean cardiac index of 4 patients with 21 mm valve replacement was （2.55 ± 0.27） L/min/m^2by catheterization, and was （2.84 ± 0.13） L/min/m^2 by echocardiography after 12 months. Conclusion： This study demonstrates that cardiac function on animals and patients return to normal activity after undergone the valve replacement, and the newly valve prosthesis shows excellent hemodynamic performance.展开更多
目的探讨乳酸林格氏液和羟乙基淀粉130/0.4容量负荷治疗的效果。方法本研究为双盲前瞻性研究。选择2011年7月—2013年3月择期胃肠外科肿瘤手术患者81例,美国麻醉医生分级Ⅰ~Ⅱ,分成2组:Ⅰ组(羟乙基淀粉130/0.4容量负荷组,n=56)和Ⅱ组(...目的探讨乳酸林格氏液和羟乙基淀粉130/0.4容量负荷治疗的效果。方法本研究为双盲前瞻性研究。选择2011年7月—2013年3月择期胃肠外科肿瘤手术患者81例,美国麻醉医生分级Ⅰ~Ⅱ,分成2组:Ⅰ组(羟乙基淀粉130/0.4容量负荷组,n=56)和Ⅱ组(乳酸林格氏液容量负荷组,n=25)。麻醉诱导后予以3次容量负荷,每次3 m L·kg?1羟乙基淀粉130/0.4或者乳酸林格氏液,7 min输毕。麻醉前后、每次容量负荷后稳定5 min,记录平均动脉压(MAP)、每博心脏输出量指数(SVI)、血容量扩张效率和氧供(DO_2)。结果麻醉诱导期间SVI和MAP均降低,两组相当;Ⅰ组和Ⅱ组患者对3次容量负荷的反应性分别为64%对20%(P<0.001)、43%对13%(P<0.001)和23%对14%(P=0.101);而第1或2次容量负荷后Ⅰ组患者达到容量最优化的累计比例低于Ⅱ组(25%对74%,P<0.001;46%对81%,P<0.001),第3次2组差异无统计学意义(88%对89%,P=0.825)。3次容量负荷后SVI上升的幅度Ⅰ组(基础值86%)高于II组(基础值68%)(P<0.001),而MAP变化2组差异无统计学意义。第1次负荷后2种液体的血容量扩张效率相当,第2次和第3次负荷Ⅰ组高于Ⅱ组。麻醉诱导和血液稀释均导致氧供下降,2种液体之间没有区别。结论容量优化治疗中胶体液的容量治疗效果优于晶体液,建议采用胶体液进行容量负荷治疗。展开更多
文摘Objective： To observe the cardiac output （CO） in animals and patients undergone valve replacement with Jiuling bileaflet mechanical valve prosthesis. Methods： 1. Animal experiments： 6 sheep that subjected to mitral replacement with a 2 I-ram-valve prosthesis were measured by open cardiac catheterization intraoperatively. Echocardiographic and open cardiac catheterization under dobutamine stress were performed on 2 sheep survival for 30 months post-operation.2. Patient measurements： CO of 14 cases of aortic valve and 10 cases of mitral valve was measured by open cardiac catheterization,and after 12 months,it was measured by echocardiography. Results： 1. Animal experiments： The mean CO of 6 sheep was 2.5 L/min intraoperatively by catheterization, and that of 2 sheep survival for 30 months post-implant was 3.0 L/min by echocardiography and 2.9 L/min by catheterization, respectively. 2. Patient measurements： The mean cardiac index of 4 patients with 21 mm valve replacement was （2.55 ± 0.27） L/min/m^2by catheterization, and was （2.84 ± 0.13） L/min/m^2 by echocardiography after 12 months. Conclusion： This study demonstrates that cardiac function on animals and patients return to normal activity after undergone the valve replacement, and the newly valve prosthesis shows excellent hemodynamic performance.
文摘目的探讨乳酸林格氏液和羟乙基淀粉130/0.4容量负荷治疗的效果。方法本研究为双盲前瞻性研究。选择2011年7月—2013年3月择期胃肠外科肿瘤手术患者81例,美国麻醉医生分级Ⅰ~Ⅱ,分成2组:Ⅰ组(羟乙基淀粉130/0.4容量负荷组,n=56)和Ⅱ组(乳酸林格氏液容量负荷组,n=25)。麻醉诱导后予以3次容量负荷,每次3 m L·kg?1羟乙基淀粉130/0.4或者乳酸林格氏液,7 min输毕。麻醉前后、每次容量负荷后稳定5 min,记录平均动脉压(MAP)、每博心脏输出量指数(SVI)、血容量扩张效率和氧供(DO_2)。结果麻醉诱导期间SVI和MAP均降低,两组相当;Ⅰ组和Ⅱ组患者对3次容量负荷的反应性分别为64%对20%(P<0.001)、43%对13%(P<0.001)和23%对14%(P=0.101);而第1或2次容量负荷后Ⅰ组患者达到容量最优化的累计比例低于Ⅱ组(25%对74%,P<0.001;46%对81%,P<0.001),第3次2组差异无统计学意义(88%对89%,P=0.825)。3次容量负荷后SVI上升的幅度Ⅰ组(基础值86%)高于II组(基础值68%)(P<0.001),而MAP变化2组差异无统计学意义。第1次负荷后2种液体的血容量扩张效率相当,第2次和第3次负荷Ⅰ组高于Ⅱ组。麻醉诱导和血液稀释均导致氧供下降,2种液体之间没有区别。结论容量优化治疗中胶体液的容量治疗效果优于晶体液,建议采用胶体液进行容量负荷治疗。
