脉搏灌注指数变异预测全麻复合硬膜外麻醉容量治疗反应性的研究

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1、万方数据复旦大学博士毕业论文脉搏灌注指数变异预测全麻复合硬膜外麻醉容量治疗反应性的研究AbilityofPlethVariabilityIndextoPredictIntraoperativeFluidResponsiVenessinPatientsunderCombinedGeneralandEpiduralAnesthesia院系：上海医学院专姓业：临床医学(八年制)麻醉学名：杜芳指导教师：薛张纲教授导师组成员：仓静主任医师张晓光主治医师万方数据目录I帅帅Ⅲ㈣咖删IIIIIIIIllollY2700512一、缩略语与符号·······

2、·································．．一””．．·1二、论文中文摘要················································一一一一一·2英文摘要················································”一一”一·4材料与方法······································一一一一一一一一一·8研究结果··················································

3、·····一一12讨论·······························································28结论·······························································33参考文献·······················································一一34三、综述综述正文················································一一一“一·37综述

4、参考文献····································一一一一一一”．．一·44四、致谢········································-··················-49万方数据缩略语与符号缩写ASAACBISBMICICOCVPDAPDCEtCOzGAGDFTHRMAC～捎PPCWPPI△POPPPVPVIPLRROCSAPSPVSVSVVTCITV英文名称中文名称AmericanSocietyofAnethesialogist美国麻醉医师学会alternatingcu

5、rrent搏动性吸收BispectralIndex脑电双频指数bodymassindex体重指数cardiacindex心指数cardiacoutput心输出量centralvenouspressure中心静脉压diastolicarterialpressure舒张动脉压directcurrent持续性吸收end．tidalcarbondioxide呼气末二氧化碳generalanesthesia全身麻醉goal—directedfluidtherapy目标导向液体治疗heartrate心率minimalalveolarconcentra

6、tion最低肺泡浓度meanarterialpressm'e’平均动脉压pulmonarycapillarywedgepressure肺动脉毛细血管楔压perfusionindex灌注指数respiratoryvariationinthe脉搏氧体表描计图波形幅plethysmographicwaveformamplitude度在呼吸周期中的变异pulse．pressurevariation动脉压变异plethvariationindex脉搏灌注指数变异passivelegraising被动腿抬高试验receiveoperatingchar

7、acteristiccurve受试者工作特征曲线systolicarterialpressure收缩动脉压systolicpressurevariation收缩压变异strokevolume每博输出量strokevolumevariation每博输出量变异Target—controlledinfusion靶控输注tidalvolume潮气量万方数据中文摘要背景：脉搏灌注指数变异(plethvariationindex，PVI)是一种基于脉搏灌注压随呼吸周期的变异，无创连续监测动脉脉搏压变化，连续描记脉搏氧波形，反映胸内压变化和回心血量之间

8、的关系，评估机体容量状态的动态血流动力学指标。其准确性受机体容量、呼吸周期及外周血管张力和顺应性等因素影响。目前的研究多集中于单纯全身麻醉，麻醉诱导后、手术开始前，患者内环境相对平稳的条件下进