肺动脉导管在危重心血管术中及术后的应用

摘要

Objective: To observe the postoperative and preoperative indicators of pulmonary artery catheter in critical cardiovascular surgery, to evaluate its clinical significance. Method: Retrospectively analyze 36 cases with critical cardiovascular surgery by the using pulmonary artery catheter from Jun. 2010 to Oct. 2011 in our hospital, They were given intravenous and inhalation general anesthesia and the right jugular vein put into the pulmonary artery catheter. The indications of pulmonary artery pressure ( PAP ), mean arterial pressure ( MAP ), pulmonary capillary wedge pressure ( PCWP ), heart rate ( HR ), central venous area ( CVP ), continuous cardiac output ( CCO ) and mixed venous oxygen saturation ( SvO2 ) were monitored before and after the surgery. Result: The basic values of MAP, SvO2 , CCO in operative surgery were lower than the preoperative surgery, ( P<0. 05 ); The basic values of PAP, PCWP, CVP, HR in operative surgery were higher than the preoperative surgery, ( P<0. 05 ); The values of CCO, HR in postoperative surgery were higher than operative surgery, P<0. 05. Conclusion: The pulmonary artery catheter can provide comprehensive and real-time hemodynamic monitoring and effectively assess the patient's circulatory status to guide the clinical treatment for the critical cardiovascular surgery, and it is worth to be applied in clinical.%目的:观察肺动脉导管(漂浮导管)在危重心血管术中、术后的指标,评价其临床意义.方法:回顾性分析我院自2010年6月至2011年10月在肺动脉导管监测下行危重心血管手术患者36例,静吸复合全身麻醉,右颈内静脉置入肺动脉导管,术中、术后监测肺动脉压 (PAP)、平均动脉压(MAP)、肺毛细血管楔压(PCWP)、心率(HR)、中心静脉区(CVP)、连续心排血量(CCO)、混合静脉血氧饱和度(SvO2).结果:术中MAP、SvO2、CCO基础值与术前相比,均明显降低,术前、术中比较差异具有统计学意义,P<0.05;术中PAP、PCWP、CVP、HR基础值与术前相比,均明显增加,术前、术中比较差异有统计学意义,P<0.05;术后的CCO、HR基础值明显高于术前,P<0.05.结论:肺动脉导管能为危重心血管手术提供全面实时的血流动力学指标监测,有效评估患者的循环功能状态,及时指导临床治疗,值得推广应用.