经食管超声及连续心输出量在非体外冠脉搭桥术中的应用

目的评价经食管超声心动图(TEE)及连续心输出量(CCO)监测在非体外冠脉搭桥术中的应用价值。方法43例行非体外冠脉搭桥的患者同时行TEE及CCO/混合静脉血氧饱和度(SVO2)监测,分别测定术前(切开心包前)、乳内动脉开放后、所有旁路开放后、关胸后(术毕)四个时段的心输出量(CCO)值、混合静脉血氧饱和度(SVO2)值、左室壁运动指数、左室射血分数(EF)值。结果与术前相比,冠脉血运重建术后心肌的室壁运动指数、左室EF值、CO值均有显著改变(P<0.05),而SVO2值除了在血运开放早期有显著意义外均维持稳定。结论在非体外冠脉搭桥术时行TEE及CCO/SVO2监测均能够及时反映患者的心功能变化,但TEE具有更直观、快捷、简便、费用低廉的优点。

Application of transoesophageal echocardiography and continuous cardiac output monitoring in patients undergoing off-pump coronary artery bypass graft

Objective To evaluate the value of transoesophageal echocardiography (TEE)and continuous cardiac output monitoring(CCO) applied to the patients undergoing off-pump coronary artery bypass graft(OPCABG).Methods Forty-three patients scheduled for OPCABG were selected.CO,S_ O_2,left ventricular(LV)wall motion score index and EF(LVEF)were measured and recorded at 4 selected time points:preoperation (before cuting pericardium),after opening left imartery,all bypass opened,after closing the sternum.Results Compared with preoperation,the LV wall motion score index,LVEF and CO were increased significantly after CABG (P<0.05).The S_ O_2 remained stable except in the early time of reperfusion of all anastomosed coronary arteries.Conclusion Either TEE or CCO/S_ O_2 monitoring can show the changes of cardiac function in time during OPCABG,but TEE monitoring is more audio-visual,rapid,simple and economical.