文档介绍：两种方法评估冠状动脉旁路移植术患者心脏收缩功能的比较摘要:目的评估经食管超声心动图(TEE)左室流出道(LVOT)测量心脏排血量(COLVOT)和经Swan-Ganz肺动脉导管测量心脏排血量(COPAC)的一致性及左室射血分数(LVEF)、左室面积变化分数(LVFAC)、右室射血分数(RVEF)之间的相关性。方法择期行冠状动脉旁路移植术的患者12例,性别不限,年龄18~70岁,体重56~84kg,ASA分级Ⅱ或Ⅲ级,术前NYHA心功能分级Ⅱ级或Ⅲ级。麻醉诱导及术中维持均采用全凭静脉麻醉。麻醉诱导气管插管后置入Swan-Ganz肺动脉导管并放置TEE探头,于插管后(T0)、停止体外循环转机后或非体外循环手术血管吻合完成后15分钟(T1)、30分钟(T2)和60分钟(T3)的数据。统计分析采用Bland-Altman一致性检验和Pearson相关系数检验。结果COPAC为(±)L/min,COLVOT为(±)L/min,两者具有良好的相关性(r=,P<),(95%CI为-~),一致性界限为-~。LVEF与LVFAC呈正相关(r=,P<),而与RVEF无相关性(r=-,p>.05)。%(95%CI为46%~%),%~%,%(95%%~%),一致性界限为-%~%。结论TEE经左室流出道测量心脏排血量和Swan-Ganz肺动脉导管测量心脏排血量之间有较强的相关性但一致性较差,TEE和PAC不能互相替代,而左室射血分数与左室面积变化分数之间存在明显偏差但有较好的相关性。关键词:经食道超声心动图;心排血量;肺动脉导管;左室流出道;射血分数;parisonoftwomethodstodetermineCardiacsystolicfunctioninpatientsundergoingcoronaryarterybypassgraftingAbstract:Objective:Todetermineifthecardiacoutput(CO)measuredbytransesophagealechocardiography(TEE)throughtheleftventricularoutflowtract(LVOT)agreeswiththatmeasuredbypulmonaryarterycatheter(PAC)andanalysisthecorrelationbetweenleftventricularejectionfraction(LVEF),leftventricularfunctionofareachange(LVFAC)andrightventricularejectionfraction(RVEF).Methods:TwelvepatientswithASAⅡ~Ⅲ(NYHAⅡorⅢ),aged18-70yearsold,weighing46-72kg,undergoingcoronaryarterybypassgrafting,,theSwan-,15,30and60minsafterterminationofcardiopulmonarybypass(CPB)orfinishedvascularanastomosisinoff--:Meancardiacoutputmeasuredbypulmonaryarterycatheter(COPAC)was(±)L/paredwith(±)L/minobtainedfromtransesophagealechocardiography(C