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《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:

23卷

期数:

2017年04期

页码:

327-329

栏目:

临床医学

出版日期:

2017-07-02

文章信息/Info

Title:

Effect of preoperative fasting 10 h on capacity status of patients with off-pump coronary artery bypass

文章编号:

1006-8147(2017)04-0327-03

作者:

王如意¹ ;  于泳浩²

（1.天津医科大学研究生院，天津 300070； 2. 天津医科大学总医院麻醉科, 天津 300052）

Author(s):

WANG Ru-yi¹ ;  YU Yong-hao²

（1.Graduate School ,Tianjin Medical University ，Tianjin 300070,China；2.Department of Anesthesiology, General Hospital, Tianjin Medical University ,Tianjin 300052, China）

关键词:

术前禁食水; 非体外冠脉搭桥术; 容量状态; 血管活性药

Keywords:

preoperative fasting;  off-pump coronary atery bypass;  fluid status; vasopressor

分类号:

R614

DOI:

-

文献标志码:

A

摘要:

目的 : 评价术前禁食水10 h对心功能正常的非体外冠脉搭桥术（OPCAB）患者容量状态的影响。方法: 择期行OPCAB患者44例，年龄50 ~75岁，ASA分级Ⅱ或Ⅲ级，NYHA分级2或3级，术前左心室射血分数(LVEF) ≥50％，左心室内径≤50 mm，术前严格禁食水10 h。患者入室后给予钠钾镁钙葡萄糖注射液维持输注，左桡动脉穿刺连接Flotrac/vigileo监测，麻醉诱导后，给予1%~1.5%七氟烷维持，行右颈内静脉穿刺，所有操作要求1 h完成，总体液量输注≤200 mL/h。记录被动抬腿试验（PLR），容量负荷试验（FC）前后各容量相关数值，即ETCO₂, CI, SVV。结果: ETCO₂, CI, SVV 3个容量指标在PLR和FC试验前后对比均无统计学意义（P＞0.05）。在PLR和FC试验中3个容量指标的容量增长百分比ETCO₂（0.35%±0.05%;0.26%±0.049%）≤5%，SVV（1.42%±0.148%;2.8%±0.274%）≤10%，CI（3.4%±0.118%;2.74%±0.131%）≤10%。结论： 手术前禁食水对心功能正常的非体外冠脉搭桥术患者容量状态无明显影响，因此如果全麻时出现低血压可给予适当的血管活性药而非无差别的容量负荷。

Abstract:

Objective: To evaluate the effect of preoperative fasting 10 h on capacity status of patients with off-pump coronary artery bypass(OPCAB)．Methods: Forty-four patients of age at 50-75 years old, ASA physical status Ⅱor Ⅲ(NYHA Ⅱ orⅢ)，and left ventricular ejection fraction(LVEF)≥50％and left ventricular end-diastolic diameter(LVEDD) ≤50 mm were strictly fasted for 10 h after operation. All patients once into the operation room were given sodium potassium, magnesium and calcium glucose injection to maintain the infusion and left radial artery puncture to connect Flotrac/vigileo monitor. After the anesthesia induction, all patients were administered 1%-1.5% sevofluraneand then carried out the right internal jugular vein line. All operations were required to complete within 1 h and the overall amount of liquid infusion of 200 mL/h was given in the meantime. Relevant date of the capacity changes, ETCO₂, CI and SVV were recorded respectively before and after Passive Leg Rising (PLR) and Fluid Challenge (FC) tests. Results: ETCO₂, CI and SVV were not statistically different in PLR test as well as FC tests (P＞ 0.05). In PLR and FC, the percentage increase of ETCO₂ (0.35%±0.05%; 0.26%±0.049%) ≤5%, SVV (1.42%±0.148%; 2.8%±0.274%) ≤10%, CI (3.4%±0.118%; 2.74%±0.131%) ≤10%. Conclusion: Effect of preoperative fasting 10 h on capacity status of patients with off-pump coronary artery bypass is not significant, and appropriate vasoactive agents rather undifferentiated capacity load should be chosen to improvement hypotension at general anesthesia .

参考文献/References:

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相似文献/References:

备注/Memo

备注/Memo:

作者简介 王如意（1985-），女，硕士在读，研究方向： 临床麻醉；

通信作者：于泳浩，E -mail：yuyonghao@126.com。

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更新日期/Last Update: 2017-07-01