Swan-Ganz飘浮导管监测血流动力学指标在心肺复苏中指导价值  

Guidance of Swan-Ganz float catheter monitoring hemodynamic indexes in cardiopulmonary resuscitation

作　　者：李志 林健球 

机构地区：[1]佛山市三水区人民医院急诊科,广东佛山528100

出　　处：《临床肺科杂志》2016年第3期396-399,共4页Journal of Clinical Pulmonary Medicine

基　　金：佛山市科技计划项目(No 2015140)

摘　　要：目的探讨利用Swan-Ganz飘浮导管监测胸外按压时血液流动力指标来指导胸外按压的幅度及频率、呼吸频率及呼吸末正压的调整的研究价值。方法选取我院从2014年7月至2015年7月68例进入急诊抢救室进行心肺复苏的患者,随机分为A、B两组,A组为治疗组,B组为观察组,每组各34例。A、B两组患者在Swan-Ganz飘浮导管置入前,均采用2010指南标准进行心肺复苏术,包括气管插管、除颤、药物的使用并详细记录,A组患者在胸外按压的同时进行Swan-Ganz Swan-Ganz飘浮导管置入,B组为观察组。对比治疗后两组患者心肺复苏的成功率和24 h存活率差异是否有统计学意义。结果 A组心肺复苏成功率为82.35%,B组心肺复苏成功率为64.71%,两组数据比较,差异具有统计学意义(P<0.05);A组患者24 h的存活率为91.18%,而B组患者在24 h的存活率仅为79.42%,两组比较差异具有统计学意义(P<0.05)。结论利用Swan-Ganz飘浮导管监测血流动力指标来指导胸外按压的幅度及频率、呼吸频率及呼吸末正压的调整以形成有效的右心室峰压及胸腔负压,达到理想的冠状动脉灌注压和心输出量以保证心肌细胞及脑细胞的血液供应,建立个体化的复苏模式从而提高心肺复苏的成功率及24 h的存活率;同时,这一成果将极大的推进心肺复苏技术的进一步发展,增强胸外按压对血流动力学影响的认识。Objective To explore the use of Swan-Ganz catheter monitoring floating chest compressions force blood flow indicators to guide the amplitude and frequency of chest compressions. Methods 68 cases in our hospital from July 2014 to July 2015 undergoing cardiopulmonary resuscitation were randomly divided into two groups, 34 cases in each group. All patients were given 2010 guidance standard cardiopulmonary resuscitation including intubation, defibrillation, and detailed records of drug use before Swan-Ganz catheter float. The group A was given chest compression simultaneously with Swan-Ganz catheter floats, and the group B was given 2010 standard cardiopulmonary resuscitation. The success rate of cardiopulmonary resuscitation and 24-hour survival rate were compared between the two groups. Results The success rate of cardiopulmonary resuscitation was 82. 35% in the group A, and 64.71% in the group B （P 〈0.05）. The 24-hour survival rate was 91.18% in the group A, and 79.42% in the group B （P 〈 0. 05）. Conclusion Swan-Ganz float catheter can be used to monitor hemodynamic indicators to guide the amplitude and frequency of chest compressions, respiratory rate and breathing to adjust PEEP to form an effective right ventricular peak pressure and negative intrathoracic pressure, and to achieve the desired coronary perfusion pressure and cardiac output. , which can furtherly improve the success rate of cardiopulmonary resuscitation, and 24-hour survival rate. At the same time, this achievement will greatly promote the further development of cardiopulmonary resuscitation techniques to enhance everyone pressing hemodynamics understanding of the chest.

关 键 词：Swan-Ganz飘浮导管 血流动力学指标 中心静脉压 连续心排血量 心肺复苏术 胸外按压 指导价值 

分 类 号：R459.7[医药卫生—急诊医学]