【摘要】 通过对40例心脏直视手术后48小时的 HR、MBP、LAP、PCWP、CVP、CI 和SVR 等血流动力学指标的监测,发现术后第一天血流动力学状态不稳定,CI 有降低趋势,而 LAP、CVP 和 SVR 却有增高趋势。26例后心病（风湿性）和14例先天性心脏病比较显示风湿性心脏病组 CI 恢复到正常水平较先心病组慢（P<0.01）。这与术前风心病心功能较差和阻断主动脉时间较长有关。这一结果提示术后应当加强和延长风心病和复杂先心病的血流动力学监护,尤其是术后第1天。LAP 对血容量和左心功能的监测较 CVP 更为重要。如果治疗后血流动力学状态仍不稳定,CI 仍低,SVR 仍持续大于 1,800 dyn·s·cm^-5,则预后不良。更多还原

【Abstract】 With monitoring of HE,MBP,LAP,PCWP,CVP,CI and SVR for the first 48 hours following intracadiac operations in 40 cases,it was found that the hemodynamic situation was not stable for the first 24 hours,CI showed a tendency of decrease,but LAP,CVP,SVR ones of increase.The comparison between 28 cases with acquired heart disease（rheumatic）and 14 cases with congenital heart disease showedin the rheumatic group the parameter of CI resumed normal level slower than in theCHD group（P<0.01）.It was attributed to the poor preoperative cardiac functionand the longer time of blocking the aorta in patients with RHD.Hence it was ne-cessery to gave intensive and long hempdynamic care for RHD and complex CHD,especially during the first 24 hours.LAP was more important in the monitoring of blood volume and left cardiacfunction than CVP.Should the hemodynamic situation not be satisfactory and CIwas still low and SVR consistantly greater than 1,800 dyn·s·cm^-5after treatment,the prognosis would be poor.更多还原