摘要
目的观察心脏瓣膜置换手术前后左室最大弹性模量(Emax)变化以评估左室心肌收缩功能。方法择期行心脏瓣膜置换术患者20例,分别于手术前、后经食管超声心动图监测左室舒张末期容积(EDV)和收缩末期容积(ESV)。静脉泵注血管活性药物使SBP升高或降低10～20mmHg以上,重复测量EDV和ESV;记录MAP、CVP和HR;计算每搏心排量(SV)、射血分数(EF)和心排血量(CO)。以MAP和ESV计算Emax。结果手术前后Emax分别为1.02mmHg/ml[95%可信区间(CI):0.72～1.32mmHg/ml)和0.74mmHg/ml(95%CI:0.51～0.97mmHg/ml),但差异无统计学意义。与术前比较,术后CVP、CO升高,HR增快(P<0.05)。结论 Emax能特异反映心肌的收缩力,不受心脏前、后负荷及HR的影响。
Objective To assesse the left ventricular myocardial contractile function by the maximum elastance （Emax） in cardiac valvular replace surgery. Methods Twenty patients undergoing elective cardiac valvular replace surgery were enrolled, and the end-diastolic volume （EDV） and the endsystolic volume （ESV） of left ventricular were measured by transesophageal echocardiography pre- and post- operation immediately. Vascular active agents were used to increase blood pressure to 10-20 mm Hg, and the EDV and ESV were measured repeated. The MAP, CVP and HR were recorded, and the stroke volume （SV）, ejection fraction （EF） and cardiac output （CA）） were calculated. The Emax were received from through MAP and ESV. Results The Emax were 1.02 mm Hg/ml （95%CI： 0. 72-1.32 mmHg/ml） and 0. 74 mm Hg/ml （95% CI： 0. 51-0. 97 mm Hg/ml） before and after operation, recpectively, but no statistical significance was observed. Compared with pre-operation ones, posvoperative CVP, HR and CO increased （P〈0. 05）. Conclusion Emax can specifically reflect myocardial contraction without influence from pre- and post-loading volumes and HR.
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2011年第11期1075-1076,共2页
Journal of Clinical Anesthesiology
基金
福建省卫生厅青年科研基金资助项目(2008-1-3)
关键词
最大弹性模量
心肌收缩功能
心脏手术
Maximum elastance
Myocardial contractile function
Cardiac surgery
作者简介
通信作者：戴双波，Email：dsbosl@126．com
