有创动脉压监测在危重肝胆手术患者中的应用

目的:探讨有创动脉压监测在危重肝胆手术患者中的应用方法与价值。方法:选择2011年2月到2015年4月在我院进行危重肝胆手术的患者110例,随机分为治疗组与对照组各55例,治疗组在围手术期给予有创动脉压监测,对照组在围手术期给予无创动脉压监测。除所用传感器不一样,均采用监护仪检测患者在围手术期内血压异常、血流动力学参数变化以及并发症发生情况。结果:治疗组围手术期的血压异常率为36.4%,对照组为12.7%,治疗组的血压异常率明显高于对照组(P0.05)。治疗组术中的平均动脉压(MAP)、每搏出量(SV)、每搏指数(SI)、心输出量(CO)和心脏指数(CI)都明显高于对照组(P0.05)。两组围手术期的感染、血肿、神经损伤、皮肤坏死等并发症发生情况对比差异无统计学意义(P0.05)。结论:有创动脉压监测在危重肝胆手术患者中的应用可有效反映血压异常情况,有利于进行心功能的判定,安全性好,有很好的应用价值。

Application Values of Invasive Arterial Pressure Monitoring for the Critically Hepatobiliary Surgery Patients

Objective:To investigate the application values of invasive arterial pressure monitoring for the critically hepatobiliary surgery patients.Methods:110 patients with critically hepatobiliary surgery selected from February 2011 to April 2015 in our hospital were randomly equally divided into treatment group and the control group, 55 patients each group. The treatment group was given the invasive arterial pressure monitoring in the perioperative period, and the patients in control group received non-invasive blood pressure monitoring in the perioperative period. Except for the difference in sensors, the patients in both groups were given the same monitor to measure the abnormal blood pressure, variation of hemodynamic parameters and complication occurrence during perioperative period.Results:The abnormality rate of perioperative blood pressure were 36.4%and 12.7 %in the treatment group and the control group, so it was significantly higher in the treatment group than control group(P<0.05). The perioperative mean arterial pressure (MAP), stroke volume (SV), stroke index (SI), cardiac output (CO) and cardiac index (CI) in the treatment group was significantly higher than that of control group (P<0.05). There were no statistically significant differences in the incidence of perioperative infection, hematoma, nerve damage, skin necrosis and other complications between two groups (P>0.05).Conclusion:The invasive arterial pressure monitoring in critically hepatobiliary surgery patients can effectively reflect the abnormality of blood pressure, so it is conductive to determine cardiac function with good security and application values.