无创血流动力学监测系统在血液透析患者中的临床应用分析  

Study of noninvasive hemodynamic monitoring system in maintenance hemodialysis patients

作　　者：孟娟[1] 彭立人[1] 周亦伦[1] 李忠心[1] 刘婧[1] 王晶[1] 周熙彬[1] 

机构地区：[1]首都医科大学附属北京朝阳医院肾内科,北京100020

出　　处：《中国医药》2007年第12期722-724,共3页China Medicine

摘　　要：目的评价无创血流动力学监测系统对维持性血液透析(MHD)患者进行实时连续性血流动力参数监测并指导治疗的可行性。方法对52例MHD患者血液透析过程,采用CHM T3002无创血流动力学监测系统进行实时连续监测,记录血流动力学各参数的变化并对其进行比较,同时就各参数变化与脱水量(FR,体重标化)进行相关分析。结果整个透析过程中,所有的血流动力学参数均有变化:心率从开始时的(71.86±8.27)次/min升高到(86.68±10.74)次/min;每搏输出量(SV)和每分钟输出量(CO)明显减低,SV由(71.22±21.32)ml/B降低到(57.95±18.26)ml/B(P=0.006),CO由(8.56±1.57)L/min降低到(5.24±1.73)L/min(P<0.01);而总外周阻力明显升高,从(1703.78±754.30)DS/cm^5升高到(2436.77±793.69)DS/cm^5(P<0.01)。透析中平均脱水量为(2.63±0.66)L,240 min时脱水量(FR)为(38.19±7.98)ml/kg。将FR与所有参数的变化行相关分析,发现仅有胸腔液体容量的变化与FR有较好的相关性(r=0.535,P=0.001),而其他参数没有明显相关。结论无创血流动力学监测系统能动态、直观地揭示血液透析中血流动力学变化,为早期干预治疗提供可靠的依据,从而减少透析中并发症的发生。Objective To analyze the value of noninvasive hemodynamic monitoring system for maintenance hemodialysis patients. Methods Fifty two patients were monitored with noninvasive hemodynamic monitoring system while undergoing hemodialysis. Parameters were recorded at 30 - min intervals. Using the Pearson method, changes of all parameters during dialysis were correlated and analyzed with the amount of fluid removed （FR） which was standardized with body weight. Results All hemodynamic parameters showed either increase or decrease. Heart rate increased significantly from （ 71.86 ± 8.27 ） to （ 86.68 ± 10.74 ） beats/min （ P 〈 0.01 ） , MAP did not change significantly. Stroke Volume （SV） and Cardiac Output （CO） decreased significantly from（ 71.22 ± 21.32 ） to （ 57. 95 ±18.267）ml/B （P〈0.01）, and from（8.56 ±1.57）to（5.24 ±1.73）L/min （P〈0.01） respectively. Total Pripheral Resistance （TPR） increased significantly from（ 1703.78 ± 754.30 ） to （ 2436.77 ± 793.69） DS/cm^5 （ P 〈 0.01 ）. The average amount of FR was （2.63 ± 0.66） L; 240-minute FR is （38.19 ± 7.98） ml/kg. ZO increased in all patients during hemodialysis session. Among all parameters, only the change of TFC showed a significant relation with FR （ r = 0. 535, P = 0. 001 ）. Condusion Noninvasive monitoring system is helpful for early diagnosis of dialysis - associated complications in maintenance hemodialysis patients.

关 键 词：血液透析 无创血流动力学监测 

分 类 号：R443[医药卫生—诊断学]