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|本期目录/Table of Contents|

Budd-Chiari 综合征分流术后血流动力学的变化特点(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
1996年第3期
页码:
134-137
栏目:
论著
出版日期:
1996-05-01

文章信息/Info

Title:
The perioperative hemodynamic changes in patients after Budd-Chiari syndrome shunt
作者:
陈绍洋 曾祥龙 李桂科 崔 勤
第四军医大学西京医院麻醉科 西安 710032
Author(s):
Chen Shaoyang Zeng Xianglong Li Guike Cui Qin
Department of Anesthesiology, Xijing Hospital, Fourth Military Medical University, Xi′an 710032
关键词:
Budd-Chiari 综合征 时期 围手术期 血液动力学
Keywords:
Budd-Chiari′s syndrome period perioperative hemodynamic
分类号:
-
DOI:
-
文献标识码:
-
摘要:
作者采用NCCOM3 型无创心血管监测仪, 观察5例Budd-Chiari综合征分流术病人围手术期的血流动力学变化。分流开放后下腔静压和门静脉压降至正常界限, 上腔静脉压明显增高; 术毕血流动力学有变化但不明显; 术后10 h 为其变化高峰, SV、SI、CO 和CI明显降低, 体循环血管阻力升高; 术后36~ 72 h 胸腔液体指数明显下降, 且伴射血速率指数和CI 降低。提示术后10 h 是围手术期循环变化高峰, 低心排高阻力是其变化特点, 术后36~ 72 h 出现变化系心源性肺组织含水量增加所致, 故需应用强心利尿措施。
Abstract:
The hemodynamic changes in 5 Budd-Chiari syndrome patients undergoing shunt operation were observed perioperatively byusing NCCOM3 non-invasive cardiovascular monitoring instrument.The results showed the inferior venacaval pressure and portal venous pressure decreaed to normal range , the supperior venacaval pressure increased significantly after the shunt was established.The hemodynamics showed slight changes at the end of the operation but most obvious changes occured 10 h after operation , SV , SI, CO and CI decreased significantly, systemic vascular resistance increased. Thoracic fluid index decreased obviously and ejection velocity index , CI decreased 36~ 72 h after the operation. The results indicated that the most significant hemodynamic changes with characteristic low cardiac output and increased vascular resistance in perioperation occured 10 h after operation.The changes which occurred 36~ 72 h after the operation were caused by cardiogenic increase of water content in the lung.Socardiotonic and diuretic drugs should be used at this period.

参考文献/References

[1]张晓林, 李桂科, 曾祥龙, 等. Budd-Chiari 综合征分流术麻醉处理.临床麻醉学杂志1991;7 (3) : 163.

[2]李 平, 宋瑞冥, 徐凯智, 等. 体外循环下Budd-Chiari 综合征根治术的麻醉处理. 中华麻醉学杂志1991; 11 (2) : 82.

[3]Orloff MJ , Girard B.Long-term results of treatment of Budd-Chiari syndrome by side to side portacaval shunt.SGO 1989; 168 (1) : 3.

[4]黄宇光, 罗爱伦, 罗来葵, 等. 布加氏综合征手术的麻醉处理.中华麻醉学杂志1990; 10 (6) : 349.

[5]Henderson JM , Warren WD, Millikan WJ , et al.Surgical options , hematologic evaluation,and pathologic changes in Budd-Ch iari syndrome.Am J Surg 1990; 159 (1) : 41.

备注/Memo

备注/Memo:
Received 1995-08-10
更新日期/Last Update: 1996-05-01