高分辨率MR血管壁成像测量壁强化指数评估颅内动脉瘤不稳定性

目的探讨高分辨率MR(HRMR)血管壁成像(VWI)所测壁强化指数(WEI)评估颅内动脉瘤不稳定性的价值。方法回顾性分析174例未破裂颅内动脉瘤患者。以3D-DSA观察动脉瘤大小、位置、形态。基于HRMR血管壁成像主观评估是否有动脉瘤壁强化(AWE),并采用软件计算WEI。采用ELAPSS及PHASES评分评估动脉瘤生长风险及破裂风险。以Spearman相关分析观察WEI与动脉瘤生长及破裂风险的相关性。结果 174例患者共248个无症状未破裂颅内囊状动脉瘤,HRMR VWI示AWE 78个、无AWE 170个。AWE与无AWE动脉瘤大小、位置、形态、ELAPSS评分、生长风险、PHASES评分、5年破裂风险差异均有统计学意义(P均0.05)。AWE动脉瘤WEI高于无AWE动脉瘤(P0.001)。Spearman相关分析显示,WEI与动脉瘤3年、5年生长风险(r_s=0.40、0.40,P均0.01)及5年破裂风险(r_s=0.24,P0.01)均呈正相关。结论 HRMR VWI所测WEI越高,提示动脉瘤不稳定性越高。     

开颅手术夹闭与血管内介入栓塞治疗破裂颅内动脉瘤疗效比较

目的对比开颅手术夹闭与血管内介入栓塞治疗破裂颅内动脉瘤疗效。方法破裂颅内动脉瘤患者68例采用随机平行对照法将其分为两组,A组给予开颅夹闭,B组给予血管内栓塞。结果 B组患者手术耗时、术中出血量、住院时间均优于A组,数据对比差异有统计学意义(P0.05),而B组患者平均费用高于A组,数据对比差异有统计学意义(P0.05)。两组治疗良好率差异无统计学意义(χ2=0.469,P=0.693);A组术后并发症发生率为24.24%(8/33)、复发率为9.09%(3/33),B组分别为6.06%(2/33)、30.30%(10/33),两组比较差异均有统计学意义(χ2=4.243、4.694,P=0.039、0.030)。结论对破裂颅内动脉瘤患者,给予血管内介入栓塞治疗具有创伤小、术后恢复快等优点,但是其复发率及花费较高,临床上需要结合患者实际情况有针对性的选择手术方式。     

高分辨MRI评估单发未破裂颅内动脉瘤稳定性

目的观察高分辨MRI(HR-MRI)评估单发未破裂颅内动脉瘤(IA)稳定性的价值。方法回顾性分析63例单发未破裂IA患者,其中稳定组32例及不稳定组31例,均接受平扫及增强HR-MR检查。对比2组一般资料及MRI所示动脉瘤位置、形态、强化形式和强化指数,绘制受试者工作特征(ROC)曲线,评估相关参数鉴别不稳定与稳定IA的效能。结果稳定组与不稳定组患者年龄、性别、既往史差异均无统计学意义(P均0.05);组间IA形态、是否为分叉动脉瘤及强化指数差异均有统计学意义(P均0.01),而位置、瘤颈宽度、瘤体深度和宽度、强化形式差异均无统计学意义(P均0.05)。ROC曲线结果显示,强化指数鉴别稳定与不稳定IA的曲线下面积(AUC)为0.82,敏感度81.7%,特异度71.9%。结论 HR-MRI可用于评估未破裂IA的稳定性。     

多层螺旋CT血管造影用于颅内动脉瘤的诊断价值

目的探讨多层螺旋CT血管造影(MSCTA)用于颅内动脉瘤的诊断价值。方法选取2016-07—2020-01间在商城县人民医院拟诊并经数字减影血管造影技术(DSA)检查确诊为颅内动脉瘤的48例患者,均行MSCTA检查。以DSA检查结果为"金标准",探讨MSCTA对颅内动脉瘤的临床诊断价值。结果 MSCTA对颅内动脉瘤的检出率及高质量分级图像的数量与DSA的差异均无统计学意义(P0.05)。结论对于拟诊为颅内动脉瘤的患者,MSCTA和DSA均有良好的颅内动脉瘤检出率及高质量图像分级。但MSCTA属于无创检查,具有操作简便、清晰度良好及可以重复检查等优势,而且费用较DSA低,对早期诊断颅内动脉瘤有较高的临床价值。     

不同Fontaine分期糖尿病下肢动脉病变的CTA特点

目的探讨不同临床Fontaine分期糖尿病下肢动脉病变的CTA特点。方法回顾性分析100例临床诊断为糖尿病下肢动脉病变,且接受双下肢动脉CTA患者的资料。根据临床表现对患者进行Fontaine分期。并对下肢动脉进行CTA分级。分析不同临床Fontaine分期患者下肢动脉的狭窄程度。结果不同临床Fontaine分期患者下肢动脉狭窄程度分级差异有统计学意义(χ~2=186.24,P0.001)。膝上动脉、膝下动脉、足背及足底动脉不同Fontaine分期的狭窄程度分级差异有统计学意义(膝上动脉:χ~2=69.24,P0.001;膝下动脉:χ~2=111.59,P0.001;足背及足底动脉:χ~2=94.15,P0.001)。膝上动脉与膝下动脉、足背及足底动脉狭窄程度分级差异有统计学意义(Z=12.59,P0.001;Z=10.47;P0.001)。膝下动脉与足背及足底动脉狭窄程度分级差异有统计学意义(Z=12.66,P0.001)。膝下动脉闭塞常伴侧支血管生成。结论 CTA诊断结果能准确反映下肢动脉临床分期,是诊断糖尿病下肢动脉的理想检查方法。     

单中心腹腔镜解剖性肝切除学习曲线研究

目的研究腹腔镜解剖性肝切除的学习曲线的情况。方法回顾性分析2002年1月至2014年12月于解放军总医院因II-VI段单发肿瘤行腹腔镜肝切除术的患者资料,所有患者均由同一组手术团队进行治疗。按照手术时间的先后顺序将患者分为3组,比较各组间的年龄、性别及Child-Pugh评分等级、手术时间、术中出血量、术中输血量、手术中转情况、术后住院时间、术后并发症发生率等指标。结果各组间的年龄、性别及Child-Pugh评分进行比较,差异无统计学意义(P0.05)。与组1比较,组2手术时间显著降低,差异有统计学意义(F=14.00,P0.001);出血量显著降低,差异有统计学意义(F=9.48,P0.001);输血量显著降低,差异有统计学意义(F=6.90,P=0.002)。组2与组3手术时间、出血量及输血量比较,差异均无统计学意义(P0.05)。不同组别间术后住院时间(F=4.90,P=0.009)及中转率(χ2=12.03,P=0.002)差异均有统计学意义。结论对于Ⅱ-Ⅵ段肿瘤的切除而言,经过36例左右的锻炼后,术者的手术效果可趋于稳定。     

前循环动脉瘤破裂并发颅内血肿的超早期显微手术治疗

目的探讨前循环动脉瘤破裂并发颅内血肿的超早期显微手术治疗。方法回顾性分析20例前循环动脉瘤破裂并发颅内血肿患者的临床资料,所有病例术前急诊行脑血管3D-CTA检查,在24小时内行显微外科动脉瘤夹闭手术。结果 20例患者共发现20个破裂动脉瘤,3个未破裂动脉瘤,破裂动脉瘤中前交通动脉瘤6个,颈内后交通动脉瘤8个,大脑中动脉瘤6个,未破裂动脉瘤中颈内后交通动脉瘤1个,脉络膜前动脉瘤1个,前交通动脉瘤1个,直接夹闭破裂动脉瘤和2个未破裂动脉瘤。术后GOS分级5分8例,4分2例,3分3例,2分4例,1分3例。结论前循环动脉瘤破裂并发颅内血肿病情发展迅速,3D-CTA应作为该类患者术前首选检查手段,超早期显微手术清除血肿夹闭动脉瘤能取得较好的效果。     

新疆和田地区维吾尔族腹股沟疝患病率初步调查

目的了解新疆和田地区某乡的维吾尔族农民腹股沟疝患病率及相关危险因素。方法采用统一的流行病学调查表,按年龄分层,抽取总人口50%的比例随机抽样,以分层等比例随机整群抽样方法对和田地区于田县拉依素乡1270例人口进行面访式问卷调查。结果本研究共调查1270人,其中腹股沟疝患者42例,腹股沟疝患病率约为3.30%。男性患病率5.35%,女性患病率为0.71%,性别上腹股沟疝患病率差异有统计学意义(χ2=21.059,P=0.000);腹股沟疝患者与正常人的年龄差异无统计学意义(t=-0.799,P=0.429);身高方面,腹股沟疝患者平均身高与正常人群比较差异无统计学意义(t=-0.701,P=0.487);体重方面,腹股沟疝患者平均体重与正常人群比较差异无统计学意义(t=0.518,P=0.607);不同家族史的腹股沟疝患病率差异有明显的统计学意义(χ2=56.130,P=0.000)。结论腹股沟疝的患病率男性明显高于女性,腹股沟疝的患病率与家族性有明显相关关系。     

血管内皮生长因子C与细胞角蛋白19检测在Ⅰ期非小细胞肺癌中的临床研究

目的探讨血管内皮生长因子C(vascular endothelial growth factor-C,VEGF-C)表达、细胞角蛋白19(cytokeratin 19,CK19)检测在Ⅰ期非小细胞肺癌(non-small cell lung cancer,NSCLC)患者生存分析中的意义。方法纳入青岛大学医学院附属医院2004年1月至2005年6月由同一组医师完成的NSCLC患者269例,均行标准肺叶切除+区域淋巴结清扫术,全部患者临床资料和随访资料完整,病理标本保留完善,手术前、后均未行放疗和化疗等辅助治疗。应用免疫组织化学链霉菌抗生物素蛋白-过氧化物酶连结法(S-P)检测癌组织标本中VEGF-C表达,以CK19标记检测肺门和纵隔淋巴结微转移的情况,结合患者临床资料、病理结果及随访数据进行统计学分析。结果269例患者的性别(Hc=1.722,P=0.084)、年龄(Hc=0.914,P=0.360)、吸烟情况(Hc=2.440,P=0.295)、病理类型(Hc=5.668,P=0.058)和肿瘤直径(Hc=0.165,P=0.920)间VEGF-C表达差异无统计学意义,不同病理分化程度间VEGF-C表达差异有统计学意义(Hc=29.178,P=0.000);患者CK19检测在性别(χ2=0.000,P=0.999)、年龄(χ2=0.005,P=0.999)、吸烟情况(χ2=2.294,P=0.317)、病理类型(χ2=0.573,P=0.289)、病理分化程度(χ2=2.927,P=0.231)和肿瘤大小(χ2=0.006,P=0.999)间差异无统计学意义;VEGF-C表达强度不同时5年生存率差异有统计学意义(χ2=37.318,P=0.000);CK19阳性和阴性表达5年生存率差异有统计学意义(χ2=39.987,P=0.000);VEGF-C表达与CK19阳性率之间差异有统计学意义(χ2=25.954,P=0.000)。结论 VEGF-C表达、CK19结果与Ⅰ期NSCLC患者术后5年生存率关系密切,VEGF-C、CK19检测有助于判断患者预后,并指导患者手术后辅助治疗,具有较大的临床意义。     

电解可脱性弹簧圈栓塞治疗颅内动脉瘤临床研究

目的探讨电解可脱性弹簧圈栓塞治疗颅内动脉瘤临床效果。方法回顾性分析2010年1月~2015年3月我院收治60例颅内动脉瘤患者,均经脑血管造影确诊为颅内动脉瘤,均为单发。根据手术方法的不同分为两组:治疗组30例,采用电解可脱性弹簧圈(GDS)栓塞治疗,对照组30例,采用开颅动脉瘤夹闭术治疗。比较两组手术结果、并发症发生率及预后(脑出血日常生活能力(ADL)评分)。结果治疗组30例患者中完全栓塞者22例(73.3%),90%栓塞者5例(16.7%),90%栓塞者3例(10.0%)。其中致密填塞者22例,弹簧圈均稳定;部分填塞者8例,其中稳定者7例,缩小者1例,且无出血。治疗组患者平均住院时间(16.1±3.1)d,明显短于对照组的(23.9±4.3)d(P0.05);两组患者手术室费用及总住院费用比较差异无统计学意义(P0.05)。治疗组无一例死亡,对照组死亡4例(13.3%),两组患者死亡率比较差异有统计学意义(χ~2=4.29,P0.05)。治疗组ADL≤Ⅱ级者明显多于对照组,差异有统计学意义(χ~2=5.73,P0.05)。治疗组术后4例(13.3%)发生并发症,其中脑梗塞、脑积水、偏瘫及肺部感染各1例。对照组术后11例(36.7%)发生并发症,其中脑梗塞3例,脑积水2例,偏瘫2例,肺部感染3例,消化道出血1例;治疗组并发症率明显低于对照组,差异有统计学意义(χ~2=4.69,P=0.03)。结论应用电解可脱性弹簧圈栓塞治疗颅内动脉瘤疗效可靠且安全,值得深入研究以推广应用。     

Vasopressor hormone response following mesenteric traction during major abdominal surgery

Background : We investigated the vasopressor hormone response following mesenteric traction (MT) with hypotension due to prostacyclin (PGI₂) release in patients undergoing abdominal surgery with a combined general and epidural anesthesia. Methods : In a prospective, randomized, placebo-controlled study we administered 400 mg ibuprofen (i.v.) in 42 patients scheduled for abdominal surgery. General anesthesia was combined with epidural anesthesia (T4-L1). Before as well as 5, 15, 30, 45, and 90 min after MT we recorded plasma osmolality, hemodynamics and measured 6-keto-PGFlα (stabile metabolite of PGI₂), TXB₂ (stabile metabolite of thromboxane A₂) active renin, and arginine vasopressin (AVP) plasma concentrations by radioimmunoassay. Catecholamine levels were assessed by high-pressure liquid chromatography (HPLC) with electrochemical detection. Results : Following MT, arterial hypotension occurred along with a substantial PGI₂ release. This was completely abolished by ibuprofen administration. Although plasma levels of 6-keto-PGF_1α (1133 (708) vs. 60 (3) ng/L, median (median absolute deviation), P=0.0001, placebo vs. ibuprofen) remained significantly elevated, blood pressure was restored within 30 min after MT in the placebo group. At the same point in time plasma concentrations of TXB² (164 (87) vs. 58 (1) ng/L, P=0.0001), epinephrine (46 (33) vs. 14 (6) ng/L, P=0.001), AVP (41 ± (18) vs. 12 (7) ng/L, P=0.0004), and active renin (27 (12) vs. 12 (4) ng/L, P = 0.001) were significantly higher in placebo-treated patients. Conclusion : Under combined general and epidural anesthesia arterial hypotension following MT due to endogenous PGI₂ release is associated with enhanced release of AVP, active renin, epinephrine and thromboxane A₂, presumably contributing to hemodynamic stability within 30 min after MT.     

A Teaspoon Pump for Pumping Blood with High Hydraulic Efficiency and Low Hemolysis Potential

Abstract: Virtually all blood pumps contain some kind of rubbing, sliding, closely moving machinery surfaces that are exposed to the blood being pumped. These valves, internal bearings, magnetic bearing position sensors, and shaft seals cause most of the problems with blood pumps. The original teaspoon pump design prevented the rubbing, sliding machinery surfaces from contacting the blood. However, the hydraulic efficiency was low because the blood was able to "slip around" the rotating impeller so that the blood itself never rotated fast enough to develop adequate pressure. An improved teaspoon blood pump has been designed and tested and has shown acceptable hydraulic performance and low hemolysis potential. The new pump uses a nonrotating "swinging" hose as the pump impeller. The fluid enters the pump through the center of the swinging hose; therefore, there can be no fluid slip between the revolving blood and the revolving impeller. The new pump uses an impeller that is comparable to a flexible garden hose. If the free end of the hose were swung around in a circle like half of a jump rope, the fluid inside the hose would rotate and develop pressure even though the hose impeller itself did not "rotate"; therefore, no rotating shaft seal or internal bearings are required.     

Microspheres Based Detoxification System: A New Method in Convective Blood Purification

Abstract: A variety of protein-bound or hydrophobic substances, accumulating as a result of pathologic conditions such as exogenous or endogenous intoxications, are removed poorly by conventional detoxification methods because of low accessibility (hemodialysis), insufficient adsorption capabilities (hemosorption), low efficiency (peritoneal dialysis), or economic limitations (high-volume plasmapheresis). Combining advantages of existing methods with microspheric technology, a module-based system was designed. Major operating parameters of the latter can be modified to allow for adjustment to individual clinical situations. An extracorporeal blood circuit including a plasmafilter is combined with a secondary high-velocity plasma circuit driven by a centrifugal pump. Different microspheric adsorbers can be combined in one circuit or applied in sequence. Thus, a prolonged treatment can be tailored using specially designed selective adsorber materials. Comparing this system with existing methods (high-flux hemodialysis, molecular adsorbent recycling system), results from our in vitro studies and animal experiments demonstrate the superior efficiency of substance removal.     

A comparison of the inhibitory effects of four volatile anaesthetics on the metabolism of chlorzoxazone, a substrate for CYP2E1, in rabbits

Background: Halothane inhibits in vitro and in vivo activity of cytochrome P-450 (CYP) 2E1. There are several fluorinated volatile anaesthetics besides halothane, and most of them are defluorinated by CYP2E1. It is unclear whether other fluorinated anaesthetics inhibit the in vivo activity of CYP2E1.
Methods: We compared the inhibitory effects of therapeutic concentrations of four inhalational anaesthetics, halothane, enflurane, isoflurane, and sevoflurane, on chlorzoxazone metabolism in rabbits receiving artificial ventilation.
Results: All four inhalational anaesthetics decreased arterial blood pressure and increased plasma chlorzoxazone concentration. However, no significant differences in the plasma chlorzoxazone concentration were found between the four anaesthetics. The estimated chlorzoxazone clearance increased after beginning inhalation with all four agents, but no significant difference in clearance was noted between agents.
Conclusions: At therapeutic concentrations, the in vivo inhibitory effect on chlorzoxazone metabolism was similar for all four inhalational anaesthetics examined, even though their chemical characteristics and extent of hepatic metabolism differ considerably.     

Tissue perfusion in relation to cardiac output during continuous positive-pressure ventilation and administration of propranolol or verapamil

Background : Our objective was to determine whether administration of propranolol or verapamil modifies the hemodynamic adaptation to continuous positive-pressure ventilation (CPPV), in particular the regional distribution of cardiac output (CO).
Methods : General hemodynamics and regional blood flows assessed by microsphere technique (15 (μm) were recorded in 16 anesthetized pigs during spontaneous breathing (SB) and CPPV with 8 cm H₂O end-expiratory pressure (CPPV8) before and after intravenous administration of propranolol (0.3 mg · kg⁻¹ followed by 0.15 mg · kg⁻¹ · h⁻¹, n=8) or verapamil (0.1 mg · kg⁻¹ followed by 0.3 mg · kg⁻¹ · h⁻¹, n=8).
Results : CPPV8 depressed CO by 25% without shifts in its relative distribution with the exception of a noteworthy increase in adrenal perfusion. Propranolol increased arterial blood pressure, and due to a fall in heart rate, CO dropped by 25%. The kidneys and, to a lesser extent, the splanchic region and central nervous system received increased fractions of the remaining CO at the expense of skeletal muscle flow. Similar patterns were seen during SB and CPPV8 such that the combination of propranolol and CPPV8 depressed CO by 50%. The circulatory effects of verapamil were less evident but myocardial perfusion tended to increase.
Conclusions : The combination of propranolol or verapamil with CPPV does not result in any specific hemodynamic interaction in anesthetized pigs, except that the combined effect of propranolol and CPPV may severely reduce CO.     

Bariatric Surgery in Some "Central and East-European (former Eastern bloc)"Countries - Current Status and Prediction for the Next Millennium

Background: Obesity is increasing globallly, including in the formerly "Eastern Bloc" countries. Methods: A survey was made of obesity and bariatric surgery. Results: In the 8 East and Central European countries studied, with total population 300 million, roughly 43% of the population was overweight (BMI 25-30), 23% obese (BMI > 30), with about 15 million people morbidly obese (BMI > 40). From 0-10 morbidly obese individuals/100,000/year undergo bariatric surgery. Conclusion: Most countries were found to provide inadequate treatment for obesity.The majority of the morbidly obese are not treated effectively. However, health-care awareness of obesity and bariatric surgeons are slowly increasing.     

Volatile anaesthetics reduce adhesion of blood platelets under low-flow conditions in the coronary system of isolated guinea pig hearts

Background : Inhibitory effects of volatile anaesthetics on platelet aggregation have been demonstrated in several studies. However, the influence of volatile anaesthetics on intracoronary platelet adhesion has not been elucidated so far.
Methods : Isolated hearts of guinea pigs were perfused with buffer in the absence or presence of volatile anaesthetics (0.5 and 1 MAC) at constant coronary flow rates of 5 ml/min for 25 min, then 1 ml/min for 30 min and again 5 ml/min for 10 min. Before, during and after low-flow perfusion, a bolus of human platelets was applied into the coronary system. To simulate thrombogenic conditions, 0.3 U/ml human thrombin was infused during low-flow perfusion and reperfusion. The number of platelets sequestered to the endothelium was calculated from the difference between coronary in- and output of platelets. The myocardial production of lactate and consumption of pyruvate and coronary perfusion pressure were also determined.
Results : At a flow rate of 5 ml/min only about 3% of the applied platelets did not emerge from the coronary system, in any group. In contrast, 13.1±1.2% (mean±SEM) of infused platelets became adherent in low-flow perfusion in the control group without anaesthetic. The adherence was reduced with each 1 MAC isoflurane (to 6.2±1.2%), sevoflurane (to 4.4±0.9%) or halothane (to 3.2±1.5%) (each P <0.05 vs. control). Volatile anaesthetic, 0.5 MAC, did not inhibit platelet adhesion to a statistically significant extent in any case. Perfusion pressure and metabolic parameters were not statistically different between the control and the hearts exposed to anaesthetics.
Conclusion : Volatile anaesthetics in a concentration of 1 MAC can reduce the adhesion of platelets in the coronary system under reduced flow conditions. This action does not arise from vasodilation or inhibition of ischaemic stress.     

Synergistic interaction between the effects of propofol and midazolam with fentanyl on phrenic nerve activity in rabbits

Background: It has been shown that the depressive effects of both propofol and midazolam on consciousness are synergistic with opioids, but the nature of their interactions on other physiological systems, e. g. respiration, has not been fully investigated. The present study examined the effect of propofol and midazolam alone and in combination with fentanyl on phrenic nerve activity (PNA) and whether such interactions are additive or synergistic. Methods: PNA was recorded in 27 anaesthetised and artificially ventilated rabbits. In three groups, propofol, fentanyl and midazolam were administered intravenously in incremental doses to construct dose-response curves for the depressant effects of each one on PNA. In another two groups, the effect of pretreatment with either fentanyl 1 μg · kg^?1 i. v. or midazolam 0.05 mg · kg^?1 i. v. on the effects of propofol and fentanyl respectively on PNA were studied. Results: Propofol and fentanyl caused a dose-dependent depression of PNA with complete abolition at the highest total doses of 16 mg · kg^?1 i. v. and 32 μg · kg^?1 i. v., respectively. In contrast, midazolam in incremental doses to a total of 0.8 mg · kg^?1 reduced mean PNA by 63%, but approximately 12% of PNA remained at a total dose as high as 6.4 mg · kg^?1. The mean ED₅₀s, calculated from dose-response curves, were 5.4 mg · kg^?1, 3.9 μg · kg^?1 and 0.4 mg · kg^?1 for propofol, fentanyl and midazolam, respectively. Initial doses of either fentanyl 1 μg · kg^?1 i. v. or midazolam 0.05 mg · kg^?1 i. v. acted synergistically with subsequent doses of either propofol or fentanyl to abolish PNA at total doses of 8 mg · kg^?1 and 8 μg · kg^?1, respectively. Conclusion: Fentanyl has a synergistic interaction with both propofol and midazolam on PNA and hence potentially on respiration.     

Influence of dopexamine hydrochloride on haemodynamics and regulators of circulation in patients undergoing major abdominal surgery

Background: Catecholaminergic support is often used to improve haemodynamics in patients undergoing major abdominal surgery. Dopexamine is a synthetic vasoactive catecholamine with beneficial microcirculatory properties. Methods: The influence of perioperative administration of dopexamine on cardiorespiratory data and important regulators of macro- and microcirculation were studied in 30 patients undergoing Whipple pancreaticduodenectomy. The patients received randomized and blinded either 2 μg · kg^?1 · min^?1 of dopexamine (n=15) or placebo (n=15, control group). The infusion was started after induction of anaesthesia and continued until the morning of the first postoperative day. Endothelin-1 (ET-1), vasopressin, atrial natriuretic peptide (ANP), and catecholamine plasma levels were measured from arterial blood samples. Measurements were carried out after induction of anaesthesia, 2 h after onset of surgery, at the end of surgery, 2 h after surgery, and on the morning of the first postoperative day. Results: Cardiac index (CI) increased significantly in the dopexamine group (from 2.61±0.41 to 4.57±0.78 1 · min^?1 · m^?2) and remained elevated until the morning of the first postoperative day. Oxygen delivery index (DO₂I) and oxygen consumption index (VO₂I) were also significantly increased in the dopexamine group (DO₂I: from 416±91 to 717±110 ml/m² · m²; VO₂I: from 98±25 to 157±22 ml/m² · m²), being significantly higher than in the control group. pHi remained stable only in the dopexamine patients, indicating adequate splanchnic perfusion. Vasopressive regulators of circulation increased significantly only in the untreated control patients (vasopressin: from 4.37±1.1 to 35.9±12.1 pg/ml; ET-1: from 2.88±0.91 to 6.91±1.20 pg/ml). Conclusion: Patients undergoing major abdominal surgery may profit from prophylactic perioperative administration of dopexamine hydrochloride in the form of improved haemodynamics and oxygenation as well as beneficial influence on important regulators of organ blood flow.