【摘要】 目的探讨经食道超声多普勒指导容量治疗在非体外循环冠脉搭桥术中对患者围术期血流动力学的影响。方法纳入我院经冠脉造影证实前降支、钝缘支和后降支冠脉病变择期行非体外循环冠脉搭桥术的患者40例。随机分为经食道超声多普勒指导容量治疗组(TEE组,n=20)和对照组(CON组,n=20)。记录麻醉诱导时、吻合前降支、钝缘支、后降支及术毕时平均动脉压和心率,术毕时统计两组患者输液量、尿量、多巴胺用量。结果与CON组相比,TEE组在吻合前降支、钝缘支、后降支及术毕时平均动脉压、输液总量、尿量明显增加,多巴胺用量明显减少。结论经食道超声多普勒指导容量治疗在非体外循环冠脉搭桥术中更有利于患者血流动力学的平稳,减少血管活性药物的使用。更多还原

【Abstract】 Objective To investigate the effect of transesophageal Doppler ultrasonography in directing volume treatment on perioperative hemodynamics in patients undergoing off-pump coronary artery bypass. Methods Forty patients undergoing off-pump coronary bypass grafting in our hospital confirmed by coronary angiography of anterior descending branch,blunt marginal branch and posterior descending branch coronary artery disease. They were randomly divided into two groups: transesophageal ultrasound guided volume therapy group( TEE group) and control group( CON group). The average arterial pressure and heart rate were recorded at the time of anesthesia induction,anterior descending branch,blunt edge branch,posterior descending branch and operation,and the amount of infusion,urine volume and dopamine dosage were counted in two groups at the time of operation. Results Compared with the CON group,the MAP,the total infusion volume and the urine volume of the TEE group were significantly increased and the dopamine dosage was significantly decreased in the TEE group before and after the anastomosis,oblique branch,posterior descending branch and operation. Conclusion Transesophageal Doppler ultrasonography in the treatment of off-pump coronary artery bypass surgery is more conducive to the patient’s hemodynamic stability and reducing the use of vasoactive drugs.更多还原