血液动力学监测系统在急性心力衰竭中的应用

The study of noninvasive hemadynamic measure system in theartic acute heart failure

目的评价无创血液动力学监测系统(Bioz.com)对急性心力衰竭(AHF)患者进行实时连续性血液动力学参数监测并指导AHF治疗的可行性.方法对35例AHF患者(治疗组)采用自身前后对照方法,在使用速尿或硝酸甘油前后采用Bioz.com系统实时连续监测心衰患者的心率(HR)、平均动脉压(MAP)、心排血量(CO)、加速度指数(ACI)、胸腔体液指数(TFC)、左室做功指数(LCWI)、外周血管阻力(SVR)的变化并对参数的变化进行比较;同时与健康体检人员(健康组)进行比较;并与使用Bioz.com系统进行监测前的AHF患者(对照组)4周死亡率进行比较.结果35例AHF患者,注入速尿或硝酸甘油后能快速增加CO、ACI、LCWI(P＜0.01),明显降低TFC、SVR(P＜0.01).与健康组各血液动力学参数进行比较,HR、MAP、CO、ACI、LCWI、TFC、SVR均有统计学差异(P＜0.05～0.01).4周死亡率治疗组与对照组分别为9/35(25.7%)、13/36(36.1%)(P＜0.01).结论Bioz.com系统在AHF患者中通过监测相关参数变化,为临床治疗和改善预后提供准确可靠依据,值得推广.

Objective To analyze the value of noninvasive hemadynamic measure system in patients with acute congestive heart failure with special reference to hemodynamic changs.Methods In this self-contrast trial,adopting noninvasive hemadynamic measure system both determined before and after intraveous lasix or nitroglycerin to 35 patients with acute congestive heart failure.Haert rade(HR),cardiac output(CO),accleration index(ACI),thorcic fluid content(TFC),left cardiac work index(LCWI),systemic vascular resistance(SVR) were measured.Compary with the control groups and healty groups.Results The results showed that noninvasive hemadynamic measure system can reflect the index of changs with hemadynamic,can increased CO,ACI,LCWI(P<0.01),decreased TFC,SVR(P<0.01).All index higter than healty groups(P<0.01).The mortilty of contrals groups higter than theartic groups(P<0.05).Conclusion Noninvasive hemadynamic measure system is an effective means to measure the index in patients with acute congestive heart failure.