犬经食管超声与Swan-Ganz导管测定的血流动力学比较

Continuous Cardiac Output Measurements with Transesophageal Doppler Echocardiography Versus Swan-Ganz Catheterization

目的对实验犬经食管超声多普勒与Swan-Ganz导管测定血流动力学指标进行比较。方法观察心肌梗死犬给予参附注射液后不同时间段2种测量方法血流动力学指标的相关性,18只杂种犬麻醉后,用Hemoson icTM100经食管超声多普勒监测仪监测心输出量(CCO)、血流加速度(Acc)、主动脉血流量(ABF)、主动脉内全身循环阻力(TSVRa)、左室射血时间(LVETi)、主动脉每搏输出量(Sva);用Swan-Ganz导管,使用HP监护仪监测PAC-CCO、SV、全身血管阻力(SVR)、肺毛细血管楔压(PAWP)。结果本文18例杂种犬经食管超声多普勒测定的CCO与Swan-Ganz导管测定的PAC-CCO之间相关性良好,相关系数r=0.965(P<0.01,n=108);另SVa与SV之间亦高度相关,r=0.837(P<0.01,n=108);TSVR与SVR之间r=0.896(P<0.01,n=108);LVETi与PAWP之间r=0.87(P<0.01)。结论Hemoson icTM100经食管超声多普勒血流动力监测仪具有较高的精确性。

Objective To compare the results of CCO measurements by echocardiography through transesophageal Doppler route with that of Swan-Ganz catheterization method in anesthetized dog models.Methods Cardiogenic shock model of canine was established by ligating the left anterior descending(LAD) of coronary artery.The transesophageal Doppler sensor was placed into the esophagus at the level of T5-6 vertebra of in 18 anesthetized dogs.The hemodynamic parameters,including CCO were recorded with HemosonicTm100;The Swan-Ganz Catheterization performed through right femoral vein.The CCO variables of both group were analyzed with linear regression procedure.Results Continuous cardiac output measured with transesophageal Doppler echocardiography was highly correlated with that measured with thermodilution technique(R=0.965,P<0.01,n=108).Conclusion Transesophageal Doppler echocardiography allows reliable continuous measurements of CCO,both easily and safely.The invasive technique of hemodynamic measurement can be replaced by non-invasive one.