左室每搏做功指数在危重患者PiCCO监测中的意义  

Value of left ventricular stroke work index in pulse index continuous cardiac output monitoring

作　　者：纪宗淑[1] 刘海燕[1] 杨启纲[1] 

机构地区：[1]安徽医科大学第一附属医院重症医学科,合肥230022

出　　处：《临床急诊杂志》2017年第8期604-607,共4页Journal of Clinical Emergency

摘　　要：目的:通过对不同疾病的危重患者脉搏指示连续心输出量(PiCCO)监测参数的比较,探讨左室每搏做功指数(LVSWI)在PiCCO监测中的意义。方法:对行PiCCO监测的危重患者资料进行回顾性分析,收集行PiCCO监测基线(0h)及24h的监测数值,选取感染性休克患者(感染性休克组)以及神经外科重症患者(神外重症组)进行比较。结果:感染性休克组心排血指数(CI)及LVSWI在0h均低于神外重症组患者(P<0.05),血管外肺水指数(EVLWI)高于神外重症组患者(P<0.05);感染性休克组24hLVSWI较0h显著升高(P<0.01),但与神外重症组比较仍低下(P<0.01)。结论:LVSWI在不同的危重患者人群中存在差异;与神经外科重症患者比较,感染性休克患者LVSWI明显低下,提示存在脓毒症心功能障碍。Objective：To investigate the value of left ventricular stroke work index（LVSWI）derived from pulse index continuous cardiac output（PiCCO）in hemodynamic monitoring.Method：Twenty-three patients with septic shock requiring hemodynamic monitoring were retrospectively enrolled as study group.11 neurosurgical critical ill patients were taken as control group.PiCCO parameters including mean arterial pressure（MAP）,central venous pressure（CVP）,cardiac index（CI）,global end diastolic volume index（GEDVI）,extra vascular lung water index（EVLWI）,systemic venous resistance index（SVRI）,and LVSWI were recorded at admission,and the first24 hrs.Result：CI and LVSWI were statistically decreased whereas EVLWI were elevated in septic shock patients compared with neurosurgical critically ill patients at baseline（P〈0.05）.There were no differences of CVP,GEDVI and SVRI between the two groups.After 24 hrs,the decreased CI and LVSWI were statisticaly elevated in septic shock patients（P〈0.05）,while no significant changes were found in control group.The elevated LVSWI was still lower in septic shock patients than control group（P〈0.05）.Conclusion：The decreased LVSWI revealed left ventricular dysfunction in patients with septic shock.

关 键 词：脉搏指示连续心输出量监测 左室每搏做功指数 感染性休克 神经外科重症 

分 类 号：R605.97[医药卫生—急诊医学]