容量負平衡改善肺癌术后右心功能的研究.docVIP

【摘要】 目的：探讨肺癌切除术后液体输入量和排出量的合理容量范围及其对右心功能的影响。方法：临床常规组术后以40～50ml/kg输入液体，试验组20～25 ml/kg并强化利尿处理。两组术前、后均用彩超测量右心血流动力学参数，记录术后液体总出入量，监测心功并比较并发症发生率。结果：术后总液体输入量，常规组是平均每日为2683±246ml，排出量（尿）2298±215ml；试验组为1725±212ml，2860±185ml。心功监测：常规组心率126±27次/min，收缩压/舒张压112±23/93±8mmHg，静脉压16±3cmH2O；试验组98±16次/min，145±18/92±7mmHg，8＋2cmH2O（P005，001）。右心血流动力学指标：常规组PASP（肺动脉收缩压）5687±931mmHg，PVRI（肺血管阻力指数）2318±622，RVEF（右心室射血分数），045±003，RVEDVI（右心室舒张末容积指数）5142±637；试验组：3117±923mmHg，1753±543，055±007，4517±471（P005，001）。实验组术后并发症明显低于常规组。结论：术后常规组总液体输入量排出量，试验组输入量排出量，心功和血流动力学状况均优于常规组。肺切除术后容量负平衡对右心功能的改善有显著作用。 【关键词】 容量 控制平衡 液体输入量和排出量 肺癌手术 右心功能 Study of control balance on less liquid volume to improve function of right heart after lung cancer operation /LIU Qing|hua，HU Guang，LIU Qing|jie//Chinese Journal of Cardiovascular Rehabilitation Medicine,2007,16(1): Abstract：Objective: To explore the reasonable limits on volume of infusion and urination and influence of right heart function after lung cancer operation.Methods:After operation both of groups are compared, clinical regular group is infused with volume of 40~50 ml/kg, experimental group with volume of 20~25 ml/kg and force diuresis Heart function is monitored, parameter of hemodynamics are measured with ultrasonic cardiogram, volume of urine and rate of complicetion are recorded.Results:Regular groups infusion volume is 2683±246ml, arination is 2298±215ml, esperimental group is 1725±212ml and 2860±185ml average per day after operation In 3 days postoperation cardio functive, regular ones heart rate is 126±27time/min, systolic blood pressure/diastolic blood pressure 122±23/93 8mmHg, CVP is 16 3 cm H2O,experimental ones is HR 98±16time/min, SBP/DBP 145±18/92 7mmHg, CVP 8 2 cm H2O In 7 days postoperation regular groups PASP is 5687 931mmHg, PVRI 2318±622, RVEF 045±003, RVEDVI 514±637, experimental groups 3117±923mmHg, 1753±543, 055±007, 4517±471 (P005,001)Conclusion:Experiment groups infusion volume urination, bu