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目的应用每搏量变异指数(stroke volume variations,SVV)评价单次输入20%甘露醇对行幕上肿瘤切除术患者血管内容量的影响。方法随机选取ASAⅠ~Ⅱ级40例全麻下择期行幕上肿瘤切除术的患者,男19例,女21例;年龄18~65岁;BMI为18~25 kg/m2。术中打开硬脑膜之前单次输入20%甘露醇1 g/kg,10 min以上输完。于甘露醇开始输入即刻记录心率(HR)、平均动脉压(MAP)、心排血量(CO)、SVV等指标,此后每5 min记录1次,连续记录1 h。结果单次输入20%甘露醇后,SVV数值在开始输入后10~20 min内明显下降(血管内容量明显增加),随后SVV数值逐渐回升(P<0.05);CO在开始输入后15~30 min内明显上升,随后逐渐下降(P<0.05);MAP和HR在输入后则没有明显变化(P>0.05)。结论单次输入20%的甘露醇后,血管内容量会出现短暂而明显的增加,SVV可准确地反映这一变化,为临床工作提供准确的评估依据。
Objective To evaluate the effect of single-dose 20% mannitol on intravascular volume in patients undergoing tumor resection using stroke volume variations (SVV). Methods Forty male and 19 female patients undergoing general anesthesia for ASA Ⅰ ~ Ⅱ undergoing general anesthesia were selected randomly. The age ranged from 18 to 65 years. The BMI ranged from 18 to 25 kg / m2. Opened 20% mannitol 1 g / kg before surgery to open the dura mater, the infusion of more than 10 min. At the beginning of mannitol, heart rate (HR), mean arterial pressure (MAP), cardiac output (CO) and SVV were recorded immediately. Results After a single injection of 20% mannitol, the value of SVV decreased significantly within 10-20 min after starting the infusion (the volume of blood vessels increased significantly), then the value of SVV gradually increased (P <0.05) min and then decreased gradually (P <0.05). MAP and HR did not change significantly after the infusion (P> 0.05). Conclusion After a single infusion of 20% mannitol, the volume of blood vessels will increase briefly and obviously. SVV can accurately reflect this change and provide an accurate assessment basis for clinical work.