二氧化碳重复吸入无创心排血量与热稀释有创心排血量相关性动物实验对比研究  

A comparitive study on correlation between partial CO_2 rebreathing and thermodilution for cardiac output monitoring by animal experiment

作　　者：刘琼[1] 黄纪坚[1] 

机构地区：[1]重庆医科大学附属第一医院急诊科,重庆400016

出　　处：《重庆医科大学学报》2007年第11期1182-1184,共3页Journal of Chongqing Medical University

摘　　要：目的:研究部分二氧化碳重复吸入无创心排血量和热稀释有创心排血量的相关性,为临床应用提供依据。方法:选用重庆地区健康雄性杂种犬6只,麻醉后气管切开气管导管置入。呼吸机控制通气下,采用美国NICO心输出量监测仪用部分二氧化碳重复吸入法连续监测无创心排血量(RBco);经右颈内静脉插入5FSwan-Gans漂浮导管至肺动脉,采用热稀释法测定有创心排血量(TDco)。用正、负性肌力药物干预心排血量,在不同条件下对两种方法所测心排血量进行自体配对相关性研究。结果:配对t检验示未用药物干预前(基础状态)两种方法测定的心排血量值无显著性差异(P>0.05),CORB和COTD呈明显的直线正相关,相关回归分析示:相关系数r=0.89,回归方程为CORB=0.78COTD+0.25;注射影响心肌收缩力药物后两种方法所测心输出量仍呈明显直线正相关,相关系数r=0.81,回归方程为CORB=0.91COTD+0.61。结论:部分二氧化碳重复吸入无创心排血量与热稀释有创心排血量间有良好的相关性,此无创心排血量监测方法为危重病人循环监测提供了一种新手段。Objective：To study the correlation between the methods of partial CO2 rebreathing （RB） technique and thermodilution （TD） technique for cardiac output in order to provide the evidence of clinical application. Methods：Six healthy anesthetized and ventilated dog were enrolled in this study. Each animal was inserted with Swan-Ganz catheter,and was installed a partial CO2 rebreathing ventilator circuit （Novametrix Medical Systems Inc,NICO）. Simultaneous measurement of CORB and COTD were performed：before and after cardiac output was varied by manipulating inotropic drugs（adrenine, dobutamine,verapamil）;Paired t-test and regression statistics were used to compare the degree of agreement between concurrent measurement of TDco and RBco. Results：Paired t-test analysis revealed no significant difference between RBco and TDco measurement at base line （P〉0.05）. Regression analysis revealed an R value of 0.89 and the regression equation was as follows：CORB=0.78COTD＋0.25;After manipulating inotropic drugs there was also a good agreement between RBco and Tdco, the correlation coefficient was 0.81,while the regression equation was CORB=0.91COTD＋0.61. Conclusion：There is a high correlation between RBco and TDco measurement. Partial CO2 rebreathing measurement provids a new noninvasive circulation monitoring method for critical patients.

关 键 词：心排血量 部分二氧化碳重复吸入 热稀释法 

分 类 号：R605.974[医药卫生—急诊医学]