去甲肾上腺素对不同方法血流动力学监测结果的影响  

Effect of norepinephrine on monitoring results of hemodynamic parameters by different methods

作　　者：李雯[1] 段军[1] 王书鹏[1] 陈德生[1] 李晨[1] 丛鲁红[2] 孙力超[3] 尹培刚[1] 李刚[1] 

机构地区：[1]中日友好医院外科重症医学科,北京100029 [2]中日友好医院教育处,北京100029 [3]中日友好医院急诊科,北京100029

出　　处：《中日友好医院学报》2017年第2期76-78,共3页Journal of China-Japan Friendship Hospital

摘　　要：目的:比较不同浓度去甲肾上腺素对压力记录分析法(PRAM)、动脉轮廓波形分析法(Vigileo system)与脉搏轮廓连续心排量监测(PiCCO)测量血流动力学参数的影响。方法:选取72例外科术后患者,其中36例(A组)应用去甲肾上腺素持续静脉泵入,速度≥0.5μg/kg/min;36例(B组)患者未应用去甲肾上腺素或应用去甲肾上腺素泵入(速度<0.5μg/kg/min),分别通过PRAM、Vigileo及PiCCO测量其每搏输出量(SV)、平均动脉压(MAP)、全身血管阻力指数(SVRI),并分析结果的一致性。结果 :A组经3种方式测得SV分别为(61.31±6.89)ml、(62.72±7.89)ml及(46.08±5.38)ml,除PRAM组与Vigileo system组之间无显著性差异(P>0.05)外,其余两组间比较均有显著性差异(均P<0.05)。A组经3种方式测得的MAP及SVRI,两两比较均无统计学差异(均P>0.05)。B组经3种方式测得的SV、MAP及SVRI,两两比较均无统计学差异(均P>0.05)。结论 :对于未应用去甲肾上腺素或应用去甲肾上腺素持续静脉泵入速度<0.5μg/kg/min的患者,PRAM、Vigileo与PiCCO测得血流动力学参数具有良好的一致性。但应用去甲肾上腺素持续静脉泵入速度≥0.5μg/kg/min的患者,PRAM与Vigileo system对SV的测量不够准确。Objective：To observe and compare the monitoring results of hemodynamie parameters in different concentration of norepinephrine by pressure recording analytical method （PRAM）,Vigileo system and classical approach.Methods：Seventy-two patients undergoing surgery were selected randomly.Thirty-six patients （group A）were pumped norepinephrine （≥0.5μg/kg/min）.Other thirty-six patients （group B）weren＇t pumped nore- pinephrine or pumped norepinephrine （〈0.5μg/kg/min）.Stroke volume （SV）,mean arterial pressure （MAP） and systemic vascular resistance index （SVRI） were monitored by PRAM,Vigileo system and classical approach, respectively.Results：The SV measured by the three methods were （61.31±6.89）ml, （62.72±7.89）ml and（46.08± 5.38）ml in group A.The value measured by PRAM and Vigileo system were significantly higher than that with PiCCO mehtod（P〈0.05）.The MAP and SVRI measured by the three methods had no statistical signifieanees（all P〉0.05）.For the patients in group B,the SV,MAP and SVRI which were measured by the three different methods had no statistical signifieances （all P〉0.05）.Conclusion：There is much agreement between the mea- surements of hemodynamic parameters by PRAM,Vigileo system and PiCCO for the patients who weren＇t pumped norepinephrine or pumped norepinephrine（〈0.5p, g/kg/min）.But there isn＇t accurate enough to the measurement of SV by PR/kM,Vigigeo system for the patients who were pumped, grepipephrine（≥0.5μg/kg/min）.

关 键 词：心输出量 去甲肾上腺素 血流动力学 

分 类 号：R459.7[医药卫生—急诊医学]