无创心输出量监测的临床应用进展  

Progress in clinical application of non-invasive cardiac output monitoring

作　　者：郁莉莉 钱何布 刘军(审校)[2] 吴允孚[2] YU Lili;QIAN Hebu;LIU Jun

机构地区：[1]苏州市第九人民医院重症医学科,江苏苏州215200 [2]南京医科大学附属苏州医院东区重症医学科

出　　处：《临床急诊杂志》2020年第11期923-926,共4页Journal of Clinical Emergency

基　　金：江苏省第五期“333工程”科研项目(No:BRA2016070);苏州市科技发展计划项目(No:SS201874)。

摘　　要：血流动力学监测技术是急危重症患者监护的一项重要手段,其中心输出量(cardiac output,CO)是较为关键的参数指标,能反映患者的血流动力学状态,有助于临床医生快速、准确地判断其病情、调整治疗方案〔1〕。目前,已经有多种血流动力学监测技术应用于临床,各种监测方法均有所利弊。有创监测方法如肺动脉漂浮导管(pulmonary artery catheterization,PAC)、脉搏指示剂连续心输出量(Pulse-indicated Continuous Cardiac Output,PiCCO)监测技术,因操作繁杂、费用昂贵、并发症多,临床应用受到一定的限制。无创血流动力学监测技术中,如心脏超声作为一种简单易行的操作技术,目前常用以评估患者的心功能及容量状态,但该项操作对临床医生的技术要求高,在某些情况下因患者因素可能造成图像不清晰,数据不精准,且心脏超声不能用以连续监测。Non-invasive cardiac output monitoring(NICOM)is a non-invasive technique for monitoring hemodynamics.Among the many methods for monitoring hemodynamics,it has unique advantages,for what it has attracted more and more attention from clinicians in recent years.NICOM technology combined with the passive leg raising test(PLR)can be used to assess the subject's systemic circulation status,to determine whether exists fluid responsive,and also to help identify the cause of dyspnea,and thus guide the clinical treatment plan.This article reviews the clinical application and progress of NICOM technology for volume status assessment,fluid optimization,and identification of certain diseases(such as shock and dyspnea).

关 键 词：血流动力学监测 无创心输出量监测技术 被动抬腿试验 容量反应性 呼吸困难 

分 类 号：R459.7[医药卫生—急诊医学]