PiCCO导管法与其他方法评估血容量的对比研究

发布时间：2018-01-12 07:19

本文关键词：PiCCO导管法与其他方法评估血容量的对比研究　出处：《中国现代医药杂志》2010年02期 　论文类型：期刊论文

【摘要】：目的比较Swan-Ganz导管、PiCCO导管和彩色多普勒超声测量心脏前负荷的准确性和灵敏度。方法通过动物实验,依次行彩色多普勒超声法测定左室舒张末期容积(LVEDV)、Swan-Ganz导管法测定肺小动脉楔压(PCWP)和PiCCO导管法测定胸腔内血容量(ITBV),并观察呼气末正压(PEEP)、血管活性药物和血容量快速变化时,上述指标相对于基础值的变化,对比研究其反映心脏前负荷的正确性与灵敏性。结果与基础值相比,在PEEP增高至10cmH2O时,CVP、PCWP增高(P0.05);血管活性药可以增高CVP值(P0.05),但不影响PCWP、LVEDV和ITBV;在血容量快速变化时,PCWP、LVEDV和ITBV产生相应的具有统计学意义的变化,而CVP的变化不明显。结论相较经典的Swan-Ganz导管和无创的超声法,PiCCO导管法测量心脏前负荷结果可信,创伤小且具可重复性,值得推广。
[Abstract]:Objective to compare the Swan-Ganz catheter PiCCO catheter and color Doppler ultrasound measurement of cardiac preload accuracy and sensitivity. The method through animal experiment, determination of left ventricular end diastolic volume by color Doppler ultrasound (LVEDV) method, the determination of pulmonary artery wedge pressure Swan-Ganz catheter (PCWP) determination of intrathoracic blood volume and PiCCO catheter (ITBV) observation, and positive end expiratory pressure (PEEP), vasoactive drugs and blood volume changes rapidly, the index changes compared to baseline value, compare the accuracy and sensitivity of reflecting cardiac preload. Results compared with the baseline, the PEEP increased to 10cmH2O, CVP, PCWP increased (P0.05); vasoactive drugs can increase the CVP value (P0.05), but not PCWP, LVEDV and ITBV; PCWP in the rapid change of blood volume, LVEDV, and ITBV have the corresponding statistically significant changes, while CVP did not change significantly. Conclusion. Compared with the classic Swan-Ganz catheter and noninvasive ultrasound, the results of the PiCCO catheter method for the measurement of cardiac load are credible, small and repeatable, and deserve to be popularized.

【作者单位】：南京医科大学附属苏州医院急诊科;南京医科大学附属苏州医院超声科;
【基金】：江苏省苏州市科技发展计划项目(SZD0437)
【分类号】：R459.7
【正文快照】： 对于休克、心功能不全和急性肺损伤(ALI)等危重患者,心脏前负荷的检测与调整是临床重要的诊治措施。心率、血压和尿量的检测是临床常用方法,但是影响因素多,灵敏度、精确性不够。Swan-Ganz导管检测肺毛细血管嵌压(PCWP)曾经作为心脏前负荷的“金标准”,PiCCO导管检测的胸腔内

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