脊柱侧弯患者术中液体入量与血管外肺水及术后呼吸功能的影响-东南大学学报医学版

脊柱侧弯患者术中液体入量与血管外肺水及术后呼吸功能的影响

单位：南京市鼓楼医院

分类号：

出版年·卷·期（页码）：2010·29·第五期（542-545）

摘要：

〔摘要〕目的探讨脊柱侧弯患者后路矫形手术中大量液体输入对血管外肺水的影响及其与术后呼吸功能的相关性。方法选择20例青少年特发性脊柱侧弯患者，行静吸复合全身麻醉，放置PICCO导管术中监测血管外肺水（EVLW），于拔除气管导管前行动态肺顺应性监测（Cdyn）。记录术毕晶胶体入量，血管外肺水指数(EVLWI)，动态肺顺应性（Cdyn）,术后拔管时间。结果脊柱侧弯后路矫形术中晶体液、胶体液量及液体总量均与血管外肺水呈线性相关(P<0.05，Pearson相关系数>0.6)，而术毕液体总入量与血管外肺水独立相关(P<0.05)。血管外肺水与肺顺应性、肺顺应性与拔管时间呈负相关(P<0.05, Spearman’s相关系数<0)；结论脊柱侧弯后路矫形术中，液体总入量是患者血管外肺水增加的独立预测因素；液体总入量的增加可降低术后肺顺应性，延长术后拔管时间。

Abstract :Objective To investigate the correlation between the amount of transfusion fluids and extravascular lung water(EVLW) include respiratory fuction in scoliosis surgery . Methods Twenty patients received general anesthesia scheduled for Scoliosis Surgery were mornitored continuously by PiCCO deviced , measured extravascular lung water index(EVLWI)；and at the same time, the amount and kinds of transfusion fluids, dynamic lung compliance and trachea canula extubated time were recorded during operation. Results Amount of colloid solution, amount of crystalloid solution and total amount of transfusion were significantly correlated with EVLWI (P<0.05，Pearson correlation coefficient>0.6), but total amount of transfusion was the independent predictor of EVLWI(P<0.05) .There was significantly negatively correlation between EVLWI and dynamic lung compliance,between dynamic lung compliance and trachea canula extubated time(P<0.05, Spearman’s correlation coefficient <0). Conclusion Total amount of transfusion during scoliosis surgery is the independent predictor of EVLWI. Increase the amount of transfusion can depress dynamic lung compliance and delay trachea canula extubated time.

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