全身生物阻抗法无创血流动力学监测与PICCO对照研究  

Comparative study of non-invasive hemodynamic monitoring using whole-body bioimpedance method and PICCO

作　　者：刘智文 俞凤[1] LIU Zhiwen;YU Feng(The First Affiliated Hospital of Anhui Medical University,Hefei 230041,Anhui,China)

机构地区：[1]安徽医科大学第一附属医院,安徽合肥230041

出　　处：《右江民族医学院学报》2024年第4期568-573,共6页Journal of Youjiang Medical University for Nationalities

摘　　要：目的通过对感染性休克患者进行全身生物阻抗法无创血流动力学监测(NICaS)与脉波指示剂连续心输出量(PICCO)监测,了解两种监测技术的相关性及一致性,评估全身生物阻抗法NICaS无创血流动力学监测在临床上的可靠性及应用价值。方法选取2021年8月至2024月1月收住安徽医科大学第一附属医院急诊重症监护室符合感染性休克诊断标准并需要血流动力学监测的患者共32例,数据收集64次,每例患者在相同的时间行PICCO血流动力学监测以及全身生物阻抗法NICaS,记录两者的测量的血流动力学数据:心输出量(CO)、心输出量指数(CI)、每搏输出量(SV)、每搏指数(SI)、外周血管阻力指数(SVRI或TPRI)等参数,并将两组参数进行相关性分析。结果NICaS方法与PICCO方法在同一时间内测量的CO、CI进行对比分析,差异无统计学意义(P>0.05),而SV、SI、TPRI、SVRI进行对比时,差异有统计学意义(P<0.05)。同一时刻全身生物阻抗法测得的CO与PICCO测得的CO值之间Bland-Altman一致性及Pearson相关性限值为-1.183~1.509 L/min和(r=0.954,P<0.001),说明具有良好的相关性。结论NICaS在重症患者血流动力学监测方面与PICCO的一致性良好,本身具有简单、无创、便捷等优点,能够有效地监测重症危重患者血流动力学变化。Objective To compare non-invasive hemodynamic monitoring using the whole-body bioimpedance method(NICaS)with pulse indicator continuous cardiac output(PICCO)monitoring in patients with septic shock.To investigate the correlation and concordance between these two monitoring techniques,and evaluate the clinical reliability and application value of NICaS.Methods The study included 32 patients diagnosed with septic shock who required hemodynamic monitoring in the Emergency Intensive Care Unit of the First Affiliated Hospital of Anhui Medical University from August 2021 to January 2024.A total of 64 data collections were performed.For each patient,PICCO and NICaS hemodynamic monitoring were conducted simultaneously.Hemodynamic parameters including cardiac output(CO),cardiac index(CI),stroke volume(SV),stroke index(SI),systemic vascular resistance index(SVRI),and total peripheral resistance index(TPRI)were recorded and analyzed for correlation between the two methods.Results Comparison of CO and CI measurements between NICaS and PICCO showed no statistically differences(P>0.05).However,significant differences were observed in SV,SI,TPRI and SVRI measurements(P<0.05).Bland-Altman analysis of CO measurements showed a consistency range of-1.183 to 1.509 L/min,while Pearson correlation analysis revealed a strong correlation(r=0.954,P<0.001)between the two methods.Conclusion NICaS demonstrates good consistency with PICCO in monitoring the hemodynamics of critically ill patients.With its simplicity,non-invasiveness,and convenience,NICaS can effectively monitor hemodynamic changes in critically ill patients.

关 键 词：感染性休克 全身生物阻抗法 脉波指示剂连续心输出量 血流动力学 

分 类 号：R331.3[医药卫生—人体生理学]