二氧化碳部分重吸入法与食管超声多普勒法用于控制性降压期间心输出量测定的相关研究

目的　采用二氧化碳部分重吸入法(RBCO)与经食管超声多普勒法(TECO)同时监测心输出量,并比较2 种测定方法的相关性。方法　25例择期颅脑手术病人(男11例,女14例),ASAⅠ~Ⅱ级。术中吸入1.0 MAC异氟醚维持麻醉。剪开硬膜后,用微量泵输注硝普钠行控制性降压。采用RBCO与TECO同体配对监测神经外科病人的心输出量,对2 种心输出量测定方法进行对比研究。结果　控制性降压期间病人心率及心输出量增加,各时点2 种方法测量结果比较无统计学差异。RBCO与TECO测定心输出量有显著的相关性(r=0.76,P<0.01),回归方程为RBCO=0.86 TECO+0.59,偏离为-0.61 L/min。结论　RBCO与TECO法用于监测神经外科患者的心输出量具有良好的相关性,可以作为动态监测神经外科术中患者血流动力学变化的手段。

Correlation Between Partial CO2 Rebreathing Technique and Transesophageal Doppler for Cardiac Output Monitoring During Controlled Hypotension

Objective To evaluate the correlation between partial CO₂rebreathing method and transesophageal doppler for cardiac output monitoring during controlled hypotension induced by sodium nitroprusside(SNP) in neurosurgical patients. Methods Twenty-five ASA Ⅰ～Ⅱ patients (11 male, 14 female), aged 19～55 years, undergoing elective neurosurgery were enrolled in this study. Anesthesia was maintained with 1.0 MACisoflurane. Controlled hypotension was performed after opening of dura with continuous infusion of SNP. Simultaneous measurements of cardiac output(CO) with partial CO₂rebreathing method(RBCO) and transesophageal doppler(TECO) were performed in 25 neurosurgical patients. Results CO and HR increased during controlled hypotension. Agood correlation was found between RBCOand TDCO(r=0.76, P<0.01), regression equation was RBCO=0.86 TECO+0.59, with a basid calculation of -0.61 L/min. Conclusion There are good correlation between two methods. Partial CO₂ rebreathing method and transesophageal doppler technique are good measurement hemodynamics for monitoring changes of COin neurosurgical patients.