连续性静脉-静脉血液滤过治疗对急性肾衰竭患者血流动学监测指标的影响  

Influence of continous veno-venous hemofiitration therapy on PiCCO monitering data

作　　者：何清[1] 冯喆[1] 王菁华[1] 常志刚[1] 唐普贤[1] 刘韬滔[1] 刘亚林[1] 

机构地区：[1]卫生部北京医院重症监护病房,100730

出　　处：《中华老年医学杂志》2010年第7期576-578,共3页Chinese Journal of Geriatrics

摘　　要：目的 探讨连续性静脉-静脉血液滤过（CVVH）治疗对使用脉搏指示连续心排血量（PiCCO）监测仪测得的血流动力学监测指标心脏指数（CI）、全心舒张末期容积指数（GEDI）、血管外肺水指数（ELWI）的影响.方法 选择北京医院重症监护病房（ICU）收治的并发急性肾衰竭的危重症老年患者12例,使用PiCCO监测仪对实施CVVH治疗的患者进行血流动力学监测,每例患者分别在暂停血滤期间及血滤进行中进行检测,并记录所测得数据.采用配对双侧t检验比较暂停血滤期间及血滤进行中两组CI、GEDI、ELWI的差异.结果 患者12例,共获取数据48组.测得暂停血滤期间及血滤进行中CI的平均值分别为（4.75±0.93）L·min^-1·m^-2及（4.69±0.89）L·min^-1·m^-2,GEDI的平均值分别为（780.60±109.30）ml/m^2及（784.75±106.20）ml/m^2,ELWI的平均值分别为（11.61±3.45）ml/kg及（11.54±3.56）ml/kg,经配对t检验差异无统计学意义（P〉0.05）.结论 CVVH不影响PiCCO血流动力学监测指标CI、GEDI、ELWI的准确性和可靠性.Objective To explore the influence of continuous veno-venous hemofiltration （CVVH） therapy on cardiac index （CD, global end-diastolic volume index （GEDI） and extravascular lung water index （ELWI） monitored by Pulse-indicated continuous cardiac output （PiCCO）. Methods The 12 critically ill patients with acute renal failure were selected consecutively from department of intensive care unit （ICU） in Beijing Hospital. The patients who received CVVH therapy were monitored by PiCCO plus device. The hemodynamic measurements were performed during the process and interruption of CVVH. Pared t-test was used to analyze the values of CI, GEDI and ELWI. Results A total of 48 groups of data from 12 patients were analyzed. There were no significant differences in CI [（4.75±0.93） L·min^-1·m^-2 vs. （4.69±0.89） L ·min^-1·m^-2], GEDI [（780.60±109.30） ml/m^2 vs. （784.75± 106.20） ml/m^2] and ELWI CC11.61±3.45） ml/kg vs. （11.54±3.56） ml/kg] between the interruption and process of CVVH, as obtained by the pared t-test （all P〉0.05）. Conclusions The CVVH therapy has no effect on the accuracy and reliability of PiCCO measurement of CI, GEDI and ELWI.

关 键 词：血流动力学现象 血液滤过 

分 类 号：R459.7[医药卫生—急诊医学]