摘要
目的:观察重症胰腺炎患者手术后6日内血流动力学指标的变化。方法:10例入ICU的重症胰腺炎患者为观察对象。在呼吸机支持治疗下置入SwanGanz导管,监测中心静脉压(CVP)、平均肺动脉压(MPAP)和肺毛细血管楔压(PCWP);右侧桡动脉置管测定平均动脉压(MAP)和心率(HR);用热稀释法测定心排血量(CO)并计算出心脏指数(CI),外周血管阻力指数(SVRI)和肺血管阻力指数(PVRI)。以10例同期乳腺手术者的血流动力学指标作为对照值。结果:与对照值比较,重症胰腺炎患者术后3日内CI降低了24.4%~37.6%(P均<0.01);PCWP、SVRI和PVRI分别升高了50.0%~60.0%、10.5%~33.2%和21.1%~42.1%(P均<0.01);术后4日~6日内SVRI和PVRI分别降低了11.8%~19.8%和5.3%~14.3%(P<0.01或P<0.05);术后6日内MPAP和HR分别升高21.1%~31.6%和15.3%~37.6%(P均<0.01);术后2日内CVP降低了12.2%~41.1%(P<0.01或P<0.05)。结论:重症胰腺炎发病后6日内主要存在严重的低血容量和外周?
Objective:To observe the changes in hemodynamics in patients with severe pancreatitis within 6 days after surgical operation.Methods:Ten patients with severe pancreatitis were selected and hemodynamic parameters including central venous pressure (CVP),mean pulmonary arterial pressure (MPAP),pulmonary capillary wedge pressure (PCWP),mean arterial pressure (MAP) and heart rate(HR) were measured by use of SwanGanz catheter,transducer and monitor under ventilation therapy.Cardiac output (CO) was measured by thermodilution and induces of SVRI,PVRI and CI were calculated.Results:Compared to control values,in patients with severe pancreatitis CI decreased by 24 4%~37 6% (all P <0 01) and PCWP,SVRI,PVRI respectively increased by 50 0%~60 0%,10 5% ̄33 2%,and 21 1%~42 1% within 3 days after operation(all P <0 01);4 to 6 days following operation,SVRI and PVRI reduced by 11 8%~19 8% and 5 3%~14 3% compared normal controls respectively,while MPAP,HR increased throughout the observation ( P <0 01).In addition,CVP was lower within 2 days after operation in patients with severe pancreatitis.Conclusions:The main problems of hemodynamics in patients with severe pancreatitis are hypovolemia and peripheral dilation within 6 days after surgical operation.
出处
《中国危重病急救医学》
CAS
CSCD
1998年第11期673-675,共3页
Chinese Critical Care Medicine