视频辅助胸腔镜手术中持续的外科手术期间心率变化监测 带切除术-试点研究
Mikkel Nicklas Frandsen1, Lin Huang2, René Horsleben Petersen2
1Section for Surgical Pathophysiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark. mikkel.nicklas.frandsen@regionh.dk.
Journal of clinical monitoring and computing
|May 27, 2023
概括
在手术后增强恢复后 (ERAS) 视频辅助胸部手术 (VATS) 叶切除术后,持续的心率变化 (HRV) 监测显示了总HRV变化减少. 手术前HRV显示昼夜变化,为未来的研究设计提供了信息.
科学领域:
- 心脏病学 心脏病学
- 胸部外科手术 胸部外科手术
- 自主神经系统研究 自主神经系统研究
背景情况:
- 心率变化 (HRV) 评估心脏自主调制,与低血压,心房动和静止不耐受有关.
- 目前存在关于最佳时间和测量特定HRV指数的知识差距.
- 需要进行特定程序的研究和持续的术后HRV监测,特别是在手术后增强恢复 (ERAS) 和视频辅助胸部手术 (VATS) 后.
研究的目的:
- 为了研究ERAS VATS脑膜切除术后HRV的术后变化.
- 在这种手术背景下建立持续HRV测量方法.
- 确定特定的HRV指标和与术后结果相关的时间点.
主要方法:
- 在28名患者的持续HRV监测中,从VATS脑膜切除手术前2天到后9天.
- 分析正常到正常节拍的标准偏差,总功率,低到高的频率变化,以及阻断波动分析.
- 评估HRV昼夜变化和设备耐受性的评估.
主要成果:
- 总HRV变异性 (正常到正常节拍和总功率之间的标准偏差) 在VATS脑膜切除术后的8天内减少.
- 低至高频率变化和阻断波动分析保持稳定.
- 手术前的HRV显示出显著的昼夜变化.
- 监测贴片的耐受性很好,尽管正确的安装需要注意.
结论:
- 这项研究提供了第一个详细的证据,证明ERAS VATS脑膜切除术后HRV总变异性降低.
- 具体的HRV测量显示了对VATS叶切除术的不同反应.
- 这些发现支持未来在术后后果的HRV研究的有效平台.
- 了解手术前HRV昼夜模式对于研究设计至关重要.
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