PiCCO技术在心脏瓣膜置换术中血流动力学监测的应用

目的评价脉搏指数连续心输出量监测（PiCCO）技术在心脏瓣膜置换手术中的应用价值。方法30例风湿性或退行性瓣膜病人在体外循环（CPB）下行瓣膜置换手术，应用PiCCO监测仪监测其心率（HR）、平均动脉压（MAP）、心脏指数（CI）、连续心排血量（CCO）、胸腔内血容量指数（ITBI）、外周血管阻力指数（SVRI）等指标，分别记录麻醉诱导前（T1）、诱导后（T2）、CPB前（T1）、CPB后（T4）及术后12h（T，）数据，并观察相关并发症。结果30例病人成功完成手术。T2时MAP较T1时明显降低（P〈0．05）；T4时ITBI较其他时点明显增多（P〈0．05），SVRI较其他时点明显降低（P〈0．05）。30例病人未发现置管即时和延迟并发症。结论PiCCO可安全用于心脏瓣膜置换手术中血流动力学监测。

Hemodynamic monitoring by pulse-indicated continuous cardiac output analysis during valve replacement cardiacsurgery

Objective To evaluate the application of pulse-indicated continous cardiac output （PiCCO） system in valve replacement cardiacsurgery. Methods Thirty patients underwent vavle replacement heart surgery under cardiopulmonary bypass （CPB） were investigated. Hemodynamic parameters were monitored by PiCCO system before inducement （T1）, after inducement （T2）, before CPB （T3）, after CPB （T4）, and 12 h after operation （T5）. Catheter-related complications were recorded as well. Results Thirty patients went through operation successfully. The mean arterial pressure at T2 were significantly lower compare to T, （P〈0.05）. ITBI at T4 significantly increased more than other time points （P〈0.05）. SVRI at T4 significantly decreased more than other time points （P〈0.05）. There was no PiCCO catheter-related complication in any patient. Conclusion PiCCO system is a safe, continuous, and muhiparameter invasive monitoring device for hemodynamic monitoring in vavle replacement surgery.