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[骨科手术中经食管超声心动图的术中血流动力学监测]

[Intraoperative hemodynamic monitoring using transesophageal echocardiography in orthopedic surgery].

作者信息

Cabrera Sch María Carolina, Vega S Raúl, Díaz Valdés A Victoria, Bermúdez B Ernesto, Santelices C Emilio

机构信息

Sección Anestesiología, Hospital Clínico Fuerza Aérea de Chile, Santiago, Chile.

出版信息

Rev Med Chil. 2008 Sep;136(9):1127-33. Epub 2008 Nov 12.

Abstract

BACKGROUND

Orthopedic surgery is commonly performed in elderly patients with higher cardiovascular surgical risk. Hemodynamic monitoring in these patients may prevent perioperative complications.

AIM

To assess the usefulness of transesophageal echocardiography (TEE) for intraoperative cardiovascular monitoring during orthopedic surgery.

MATERIAL AND METHODS

Patients older than 65 years subjected to orthopedic surgery using general anesthesia and with a high cardiovascular risk were studied. Intraoperative TEE was performed to assess intravascular volume, myocardial contractility and the presence of myocardial ischemia.

RESULTS

Fifty three patients aged 72+/-5 years were studied. Hemodynamic stability was detected in 68% of patients, mainly reflected as episodes of hypovolemia. Myocardial ischemia was detected in two patients and embolic episodes in six (11%).

CONCLUSIONS

Intraoperative TEE was useful for the hemodynamic evaluation of patients with high cardiovascular risk.

摘要

背景

骨科手术常在心血管手术风险较高的老年患者中进行。对这些患者进行血流动力学监测可预防围手术期并发症。

目的

评估经食管超声心动图(TEE)在骨科手术中进行术中心血管监测的实用性。

材料与方法

研究年龄大于65岁、接受全身麻醉且心血管风险高的骨科手术患者。术中进行TEE以评估血管内容量、心肌收缩力及心肌缺血情况。

结果

研究了53例年龄为72±5岁的患者。68%的患者检测到血流动力学稳定,主要表现为血容量不足。两名患者检测到心肌缺血,六名患者(11%)检测到栓塞事件。

结论

术中TEE对心血管风险高的患者进行血流动力学评估有用。

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