PiCCO与超声心动图心功能测定的对比研究  

Comparative study on cardiac function test with PiCCO analysis and echocardiography

作　　者：王绍林 张进 俞蕾 刘小彬 耿峰 

机构地区：[1]芜湖市第二人民医院麻醉科,安徽芜湖241000 [2]芜湖市第二人民医院超声科,安徽芜湖241000

出　　处：《皖南医学院学报》2013年第2期144-146,共3页Journal of Wannan Medical College

基　　金：芜湖市科技计划项目(2011卫生5-2)

摘　　要：目的:评价脉搏指示连续心排血量(PiCCO)技术在有心内分流患者心脏手术中的应用价值。方法:19例在CPB下行心脏手术患者,男12例,女7例,年龄14～72岁。根据超声检测的心内分流情况将患者分为A(无或轻度心内分流,8例)、B(中度及以上心内分流,11例)两组。入室后建立PiCCO监测,待患者安静后由超声科医师进行超声心动图检查,记录心内血液反流情况以及心输出量(COe1)、每搏量(SVe1)和同时点PiCCO测量的COp1、SVp1。插管后5min再次记录超声测量的COe2、SVe2以及PiCCO测量的COp2、SVp2。结果:A组患者COp1与COe1、COp2与COe2、SVp1与SVe1、SVp2与SVe2的相关系数分别为0.943、0.866、0.858、0.966,P<0.01,具有高度相关性。B组患者COp1与COe1、COp2与COe2、SVp1与SVe1、SVp2与SVe2的相关系数分别为0.622、0.625、0.647、0.724,P<0.05,具有中度相关性。结论:对于无或轻度心内分流患者,PiCCO监测准确可靠,而对于存在中度或以上心内分流患者,PiCCO监测结果需结合其他的临床观察指标综合分析,要重点关注心功能监测结果的变化趋势。Objective： To assess the application value of pulse-indicated continuous cardiac output （PiCCO） analysis in patients with intra-cardiac shunts undergoing cardiac surgery. Methods：Nineteen patients （ 12 male, 7 female） aged 14 -72 years, scheduled for heart operation under car- diopulmonary bypass （CPB） were allocated to either group A（ free of or mild intra-eardiac shunt, n = 8 ） or group B （ moderate or severe intra-car- diae shunt, n = 11 ） on hemodynamic measurement basis by echocardio- graphy. PiCCO analysis was carried out upon entry and echocardio^aphy was performed after sedation. Two groups of patients were monitored with color Doppler echoeardiography concerning the condition of ventricle backflow, cardiac output （ COel ） and stroke volume （ SVel ） as well as simultaneous COpl and SVpl with PiCCO system. After 5 min of intuba- tion, the patients were further monitored for COe2 and SVe2 as well as COp2 and SVp2. Results： The coefficient correlation for COp1 , COe1 , COp2 ,COe2, SVp1 , SVe1 , SVp2 and SVe2 in group A was 0. 943,0. 866, 0. 858 and 0. 966, respectively （P 〈 0.01 ） , which suggested high corre- lation, whereas the coefficient correlation was moderately correlated in group B by 0. 622, 0. 625, 0. 647 and 0. 724, respectively for the corre- sponding indexes described above （P 〈 0. 05 ）. Conclusion： PiCCO analysis may accurately reveal the CO and SV for patients with no or mild range of intra-cardiac shunt, yet the PiCCO t results in those with moderate or severe intra-cardiac shunt still entail comprehensive ob- servation of the clinical indexes and changes of cardiac function monitored in procedure.

关 键 词：血流动力学 脉搏指示连续心排血量 彩色多普勒 超声 监测 

分 类 号：R654.2[医药卫生—外科学] R614[医药卫生—临床医学]