对比无创血流动力学监测系统与热稀释法在急性农药中毒患者病情监测中的应用效果  

A retrospective comparative study on the clinical guidance value of non-invasive hemodynamic monitoring system and thermodilution in patients with acute pesticide poisoning

作　　者：相婷婷 于杰[1] XIANG Ting-ting;YU Jie(Emergency Department,Lianyungang First People's Hospital,Jiangsu 222000,China)

机构地区：[1]连云港市第一人民医院急诊抢救室,江苏222000

出　　处：《工业卫生与职业病》2023年第1期32-36,共5页Industrial Health and Occupational Diseases

基　　金：江苏省青年医学重点人才培养计划(QNRC2016442)。

摘　　要：目的对比无创血流动力学监测系统与热稀释法在急性农药中毒患者病情监测中的效果。方法选取本院112例急性农药中毒患者为研究对象,按监测方法分为无创组与热稀释组,每组各56例。无创组应用无创血流动力学监测系统,热稀释组应用热稀释法。对比两组血药浓度、心功能指标、血气状态及不良事件发生率。结果无创组呼吸机使用天数、胆碱酯酶(ChE)活力恢复用时、监测时间、住院时间短于热稀释组,阿托品用量及住院费用均少于热稀释组(t/χ^(2)=7.295、8.324、4.100、7.421、5.549、11.373,P<0.05);无创组治疗第60、120、240 min时血药浓度均低于热稀释组(t=6.34、8.30、10.31,P<0.05);治疗后无创组患者的左心室做功指数(LCWI)、左心室做功(LCW)、每搏输出量(SV)和心输出量(CO)均高于热稀释组(t=6.66、7.45、5.45、5.46,P<0.05);治疗后无创组PaO_(2)高于热稀释组,PaCO_(2)和pH值低于热稀释组(t=4.84、5.54、4.85、6.63,P<0.05);无创组不良事件发生率低于热稀释组(χ^(2)=4.91,P<0.05)。结论与热稀释法对比,无创血流动力学监测系统在急性农药中毒患者治疗中能更及时获得血流动力学数据,有助于实时调整治疗方案,促进病情转归,适合临床推广。Objective To compare the effect of noninvasive hemodynamic monitoring system and thermodilution method in monitoring the condition of patients with acute pesticide poisoning.Methods A total of 112 patients with acute pesticide poisoning in our hospital were selected as the research objects and divided into the non-invasive group and the thermodilution group according to the monitoring method,with 56 cases in each group.Non-invasive hemodynamic monitoring system was used in the non-invasive group,and thermodilution was used in the thermodilution group.The blood drug concentration,cardiac function index,blood gas status and the incidence of adverse events were compared between the two groups.Results The days of ventilator use,the time of cholinesterase(CHE)activity recovery,the monitoring time and the length of hospital stay in the non-invasive group were shorter than those in the thermodilution group,and the dosage of atropine and the cost of hospital stay in the non-invasive group were less than those in the thermodilution group(t/χ^(2)=7.295,8.324,4.100,7.421,5.549,11.373;P<0.05).The blood drug concentration in the non-invasive group was lower than that in the thermodilution group at the 60th,120th and 240th min after treatment(t=6.34,8.30,10.31;P<0.05).After treatment,the levels of left ventricular work index(LCWI),left ventricular work(LCW),stroke volume(SV)and cardiac output(CO)in the non-invasive group were higher than those in the thermodilution group(t=6.66,7.45,5.45,5.46;P<0.05).PaO_(2)was higher,PaCO_(2)and pH were lower in the noninvasive group than in the thermodilution group(t=4.84,5.54;4.85,6.63;P<0.05),and the incidence of adverse events was lower in the non-invasive group than in the thermodilution group(χ^(2)=4.91;P<0.05).Conclusion Compared with the thermodilution method,the non-invasive hemodynamic monitoring system can obtain the hemodynamic data more timely in the treatment of patients with acute pesticide poisoning,which is helpful to adjust the treatment plan in real time,promote the progn

关 键 词：无创血流动力学监测系统 热稀释法 急性农药中毒 心功能 血流动力学 血气状态 

分 类 号：R825.92[医药卫生—临床医学]