无创心输出量测定在重症肺炎合并心衰患儿治疗中的应用  

Application of non-invasive cardiac output measurement in the treatment of children with severe pneumonia complicated with heart failure

作　　者：刘婷婷[1] 张秋月[1] 姜春明[1] LIU Ting-ting;ZHANG Qiu-yue;JIANG Chun-ming(Department of Pediatrics,The First Affiliated Hospital of Harbin Medical University,Harbin 150001,China)

机构地区：[1]哈尔滨医科大学附属第一医院儿科,黑龙江哈尔滨150001

出　　处：《哈尔滨医科大学学报》2021年第2期148-152,共5页Journal of Harbin Medical University

摘　　要：目的评价无创超声心输出量监测仪(ultrasonic cardiac output monitor, USCOM)在重症肺炎合并心衰患儿治疗中的应用价值。方法选取哈医大一院儿科重症监护室收治重症肺炎合并心力衰竭患儿40例,随机分为USCOM监测组和非USCOM监测组,同期门诊健康体检婴儿20例作为正常对照组。应用超声心输出量监测仪记录正常对照组血流动力学指标及USCOM监测组应用心血管活性药物治疗前后血流动力学指标,观察USCOM监测组与正常对照组心功能指标差异,分析非USCOM监测组与USCOM监测组患儿使用米力农、西地兰的剂量变化。结果应用USCOM检查记录血流动力学指标,USCOM监测组与正常对照组相比,心功能指标存在差异,差异有统计学意义(P<0.05);USCOM监测组治疗后心功能指标较治疗前改善,差异有统计学意义(P<0.05);USCOM监测组与非USCOM监测组患儿相比,使用米力农、西地兰的剂量减少,差异有统计学意义(P<0.05)。结论 USCOM可明确儿童的血流动力学状态,帮助临床识别心衰患儿;应用USCOM监测血流动力学可减少血管活性药物使用剂量,指导药物的合理应用。Objective To evaluate the value of non-invasive Ultrasonic cardiac output monitor(USCOM) in the treatment of children with severe pneumonia complicated with heart failure. Methods Forty children with severe pneumonia complicated with heart failure admitted to the pediatric intensive care unit of Harbin Medical University were randomly divided into USCOM monitoring group and non-USCOM monitoring group. In addition, twenty healthy infants with outpatient health checkups were taken as normal control group. The hemodynamic parameters of the control group and USCOM monitoring group were recorded by the USCOM. The differences of cardiac function indexes between USCOM monitoring group and the normal control group were observed. To compare the dosage of milrinone and cedilanide between non-USCOM group and USCOM group. The dose of milrinone and cedilan in the non-USCOM monitoring group and the USCOM monitoring group were compared and analyzed. Results The hemodynamic parameters were recorded by USCOM. There were significant differences in cardiac function between USCOM group and normal control group(P<0.05). After treatment, cardiac function index of USCOM monitoring group was improved(P<0.05). The dosage of milrinone and cedilan in USCOM group was significantly lower than that in monitoring non-USCOM group(P<0.05). Conclusion USCOM can identify the hemodynamic status of children, and help clinians identify children with heart failure. Using USCOM to monitor hemodynamics can reduce the dose of vasoactive drugs and guide rational application of drugs.

关 键 词：重症肺炎 无创超声心输出量 心力衰竭 儿童 

分 类 号：R725.6[医药卫生—儿科]