超声心动图与脉搏指示连续性心输出量监护心源性休克患者心输出量的效果比较
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摘要
目的比较脉搏指示的连续性心输出量(Pi CCO)监测技术以及超声心动图(UCG)测定ICU心源性休克患者心输出量(CO)的效果。方法选择心源性休克患者共40例,均进行Pi CCO及超声心动图测定CO。结果 3例患者因未获得满意的图像而放弃。超声心动图和Pi CCO测定的CO分别为(3.19±0.66)、(3.35±0.67)mL/min,差异无统计学意义(P>0.05)。结论超声心动图测定CO具有快速、准确、无创等优势,适合于ICU心源性休克患者监护。
Objective To compare effect of ultrasonic cardiogram( UCG) and pulse-indicated continuous cardiac output( Pi CCO) in the measurement of cardiac output( CO) in cardiogenic shock. Methods The CO of 40 cardiogenic shock patients were monitored by Pi CCO and UCG. Results There were 3 patients abandoned the monitoring due to unsatisfactory image. CO values by UCG and Pi CCO were( 3. 19 ± 0. 66),( 3. 35 ± 0. 67) mL/min,respectively,but showed no significant differences in two measures( P > 0. 05). Conclusion UCG is featured by rapid,accurate and noninvasive measurement,and it is suitable for the measurement of CO in ICU patients with cardiogenic shock.
Objective To compare effect of ultrasonic cardiogram( UCG) and pulse-indicated continuous cardiac output( Pi CCO) in the measurement of cardiac output( CO) in cardiogenic shock. Methods The CO of 40 cardiogenic shock patients were monitored by Pi CCO and UCG. Results There were 3 patients abandoned the monitoring due to unsatisfactory image. CO values by UCG and Pi CCO were( 3. 19 ± 0. 66),( 3. 35 ± 0. 67) mL/min,respectively,but showed no significant differences in two measures( P > 0. 05). Conclusion UCG is featured by rapid,accurate and noninvasive measurement,and it is suitable for the measurement of CO in ICU patients with cardiogenic shock.
引文
[1]陈玉国.急性心肌梗死并发心源性休克的治疗进展[J].中华急诊医学杂志,2012,21(7):680-682.
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[4]Tan H L,Pinder M,Parsons,et al.Clinical evaluation of USCOM ultrasonic cardiac output monitor in cardiac surgical patients in intensive care unit[J].Br J Anaesth,2005,94(3):287-291.
[5]van Lelyveld-Haas L E,van Zanten A R,Borm G F,et al.Clinical validation of the non-invasive cardiac output monitor USCOM-1A in critically ill patients[J].Eur J Anaesthesiol,2008,25(11):917-924.
[6]曹铁生,丁康,王泓,等.多普勒超声法测定心输出量存在的误差和校正方法[J].中华超声影像学杂志,2005,14(10):747-749.
[7]Michard F,Alaya S,Zarka V,et a1.Global end—diastolic volume as all indicator of cardiac preload in patients with septic shock[J].Chest,2003,124:1900-1908.
[8]刘继海,于学忠,王仲,等.无创超声心输出量测定对急诊感染性休克患者血流动力学状态评价的临床研究[J].中国急救医学,2011,31(3):193-196.
[9]Cao T,Shapiro S M,Berson M M,et al.Influence of cardic motion on Doppler measurements using in vitro and in vivo models[J].J Am Coll Cardiol,1993,22:271-276.
[10]张艳梅,贺勇,黄鹤.超声心动图监测重症心肌炎置入ECMO心功能变化1例[J].中国超声医学杂志,2014(7):645-645.
[11]余正春,马小静,夏娟,等.超声心动图监测体外膜式氧合治疗心源性休克的价值[J].中华医学超声杂志:电子版,2017,14(4):292-296.
[12]李启飞,夏瑞,陈益,等.经食管超声心动图测量右美托咪定对不同年龄段患者心输出量的影响[J].心肺血管病杂志,2016(2):132-134.
[13]周婷,曹荔,吴云.超声心动图测量正常胎儿心输出量的研究及临床意义[J].中国临床研究,2015,28(9):1222-1224.
[14]王守君,王世富,翟萍,等.床旁超声心动图监测重症患者血容量及心脏功能的临床研究[J].临床超声医学杂志,2016,18(3):200-202.
[15]须晋,赵娜,王仲.超声心输出量监测技术(USCOM)的应用及发展前景[J].中华急诊医学杂志,2014,23(6):712-715.
[16]张晋峰,郭浩,王治,等.围术期Flotrac/Vigileo与经食管超声心动图监测心输出量相关性比较[J].中国基层医药,2016(17):2605-2608.
[17]王振红,史宏伟,魏海燕,等.经二尖瓣超声多普勒法与经肺动脉导管热稀释法测定心脏指数的一致性研究[J].生物医学工程与临床,2014(5):448-453.
[2]Krishnagopalan S,Kumar A,Parrillo J E,et al.Myocardial dysfunction in the patient with sepsis[J].Curr Opin Crit Care,2002,8:376-388.
[3]朱志云,李凌,叶记录.早期中心静脉血氧饱和度监测在严重脓毒症与感染性休克中的意义[J].中国危重病急救医学,2008,20:501-502.
[4]Tan H L,Pinder M,Parsons,et al.Clinical evaluation of USCOM ultrasonic cardiac output monitor in cardiac surgical patients in intensive care unit[J].Br J Anaesth,2005,94(3):287-291.
[5]van Lelyveld-Haas L E,van Zanten A R,Borm G F,et al.Clinical validation of the non-invasive cardiac output monitor USCOM-1A in critically ill patients[J].Eur J Anaesthesiol,2008,25(11):917-924.
[6]曹铁生,丁康,王泓,等.多普勒超声法测定心输出量存在的误差和校正方法[J].中华超声影像学杂志,2005,14(10):747-749.
[7]Michard F,Alaya S,Zarka V,et a1.Global end—diastolic volume as all indicator of cardiac preload in patients with septic shock[J].Chest,2003,124:1900-1908.
[8]刘继海,于学忠,王仲,等.无创超声心输出量测定对急诊感染性休克患者血流动力学状态评价的临床研究[J].中国急救医学,2011,31(3):193-196.
[9]Cao T,Shapiro S M,Berson M M,et al.Influence of cardic motion on Doppler measurements using in vitro and in vivo models[J].J Am Coll Cardiol,1993,22:271-276.
[10]张艳梅,贺勇,黄鹤.超声心动图监测重症心肌炎置入ECMO心功能变化1例[J].中国超声医学杂志,2014(7):645-645.
[11]余正春,马小静,夏娟,等.超声心动图监测体外膜式氧合治疗心源性休克的价值[J].中华医学超声杂志:电子版,2017,14(4):292-296.
[12]李启飞,夏瑞,陈益,等.经食管超声心动图测量右美托咪定对不同年龄段患者心输出量的影响[J].心肺血管病杂志,2016(2):132-134.
[13]周婷,曹荔,吴云.超声心动图测量正常胎儿心输出量的研究及临床意义[J].中国临床研究,2015,28(9):1222-1224.
[14]王守君,王世富,翟萍,等.床旁超声心动图监测重症患者血容量及心脏功能的临床研究[J].临床超声医学杂志,2016,18(3):200-202.
[15]须晋,赵娜,王仲.超声心输出量监测技术(USCOM)的应用及发展前景[J].中华急诊医学杂志,2014,23(6):712-715.
[16]张晋峰,郭浩,王治,等.围术期Flotrac/Vigileo与经食管超声心动图监测心输出量相关性比较[J].中国基层医药,2016(17):2605-2608.
[17]王振红,史宏伟,魏海燕,等.经二尖瓣超声多普勒法与经肺动脉导管热稀释法测定心脏指数的一致性研究[J].生物医学工程与临床,2014(5):448-453.