Buniatian A A, Sandrikov V A, Iavorovskiĭ A G, Meshcheriakov A V, Flerov E V, Iumatov A E, Kovalevskaia O A
Anesteziol Reanimatol. 2000 Sep-Oct(5):16-21.
57 ischemic heart disease (IHD) patients entered the study of right and left heart function at different stages of anesthesia and operation to reveal possible reasons of myocardial dysfunction and to propose effective prevention of this dysfunction. All the patients were operated on under multicomponent balanced anesthesia (relanium, fentanyl, arduan, nitric oxide with oxygen 1:1). Left ventricular function was assessed at Doppler echocardiography, right ventricular function--at catheterization of the lung artery with a Swan-Ganz catheter with low time constant. Hemodynamic monitoring was made with a domestic MX-04 monitor. It was found that in the preperfusion period diastolic function of the right and left ventricles is impaired much more than the systolic one. The conditions of anesthesia and operation affect right ventricular function more than the left one. Diastolic and systolic right ventricular dysfunctions were observed at all stages and three stages of the operation, respectively. Diastolic and systolic left ventricular dysfunction was observed at four and one stages, respectively. Basic causes of the above systolic and diastolic disorders in the preperfusion period may be tachycardia, arterial hypertension, reduction of the preloading and increased postloading (for the right ventricle) in artificial lung ventilation.
57例缺血性心脏病（IHD）患者进入研究，观察其在麻醉和手术不同阶段的左右心功能，以揭示心肌功能障碍的可能原因并提出有效预防该功能障碍的方法。所有患者均在多组分平衡麻醉（氟哌啶、芬太尼、阿曲库铵、一氧化氮与氧气按1:1混合）下进行手术。通过多普勒超声心动图评估左心室功能，使用具有低时间常数的Swan-Ganz导管经肺动脉插管评估右心室功能。使用国产MX-04监护仪进行血流动力学监测。结果发现，在预灌注期，左右心室的舒张功能比收缩功能受损更严重。麻醉和手术条件对右心室功能的影响大于左心室。在手术的所有阶段和三个阶段分别观察到舒张期和收缩期右心室功能障碍。在四个阶段和一个阶段分别观察到舒张期和收缩期左心室功能障碍。预灌注期上述收缩期和舒张期紊乱的基本原因可能是心动过速、动脉高血压、前负荷降低以及人工肺通气时后负荷增加（针对右心室）。
