小児外科に於ける Swan-Ganz Catheter による血行動態に関する研究 : 各種外科的疾患に於ける Swan-Ganz Catheter による術前術後の血行動態に関する研究(第6報)

抄録

The data concerning pre- and postoperative hemodynamics in 10 cases subjected to pediatric surgery were analysed with an aid of the Swan-Ganz catheter. The results obtained were as follows; 1) The catheter was easily inserted in all cases except infants. 2) There was no complication related to the procedures of insertion or indwelling of the catheter. 3) Seven out of 10 patients had been satisfactorily treated for compromised hemodynamics before operation, and then underwent an elective operation. Their hemodynamic data showed higher CI, PR and LW, lower PAP, PWP, TPR, PAR and RW compared with those of adults This was more prominent in the group of younger children. 4) The hemodynamics in children were classified into 4 types. Type A; CI≧5 L/min/M^2, PWP≦7mmHg Type B; CI≧5 L/min/M^2, PWP>7mmHg Type C; CI<5 L/min/M^2, PWP≦7mmHg Type D; CI<5 L/min/M^2, PWP>7mmHg 5) The hemodynamic pattern of the patients mentioned in 3) showed Type A. The types of hemodynamics were various in the early postoperative period, and become Type A ultimately. These results suggested that Type A was standard (hemodynamics) in childhood. This type of hemodynamics is similar to that of the hyperdynamic state in adults. 6) Hemodynamics of Type B was found in the condition of cardiac hypofunction with overhydratlon. The condition of these patients was poor and they were vulnerable to complication. 7) Type C was seen in cases younger than 1 year of age and in cases subjected to major operation. 8) Type D was seen in patients with poor condition and it suggests cardiac hypofunction.