无创血流动力学监测仪在重症急性胰腺炎合并肺水肿患者中的临床应用

Clinical study of non-invasive hemodynamic monitor system in the severe acute pancreatitis combined with pulmonary edema

目的 研究无创血流动力学监测仪在重症急性胰腺炎（SAP）合并肺水肿患者鉴别诊断中的意义.方法 回顾性分析29例SAP早期液体复苏过程中出现肺水肿患者的临床资料.根据患者出院诊断等分为观察组（非心源性肺水肿）18例和对照组（心源性肺水肿）11例.将两组无创血流动力学监测数据进行比较.结果 对照组心排出量[（3.34±1.09）L/min]、心脏指数[（2.06±0.46）L/（min·m2）]、心脏搏出量[（41.89±13.72）ml]、心搏指数[（25.59±7.32）ml/m2]、加速指数[（59.24±28.41）L/100 s2]、左心室工作指数[（2.09±0.67）（kg·m）/m2]、左心室射血时间[（254.32±27.34）ms]、射血分数（0.37±0.03）和速度指数[（27.11±11.32）L/100 s]较观察组[分别为（4.12±1.06）L/min、（2.64±0.48）L/（min·m2）、（46.21±11.81）ml、（28.87±5.32）ml/m2、（79.43±29.01）L/100 s2、（3.21±0.84）（kg·m）/m2、（281.29±29.11）ms、0.54±0.04、（39.34±12.11）L/100 s]显著降低（P〈0.01）;射血前期[（116.54±22.37）ms]和收缩时间比（0.48±0.04）较观察组[分别为（95.24±21.41）ms、0.36±0.02]显著增高（P〈0.01或〈0.05）.结论 无创血流动力学监测仪为SAP合并肺水肿患者鉴别诊断提供了较好的依据.

Objective To study the significance of the non-invasive hemodynamic monitor system in the differential diagnosis of severe acute pancreatitis （SAP） combined with pulmonary edema. Methods Twenty-nine cases of SAP during fluid resuscitation treatment combined with pulmonary edema were reviewed and the data of the non-invasive hemodynamic monitor system was analysed and summarized.According to the diagnosis on discharge, 18 patients were enrolled in test group （noncardiogenic pulmonary edema group） and 11 patients were enrolled in control group （cardiogenic pulmonary edema group）. The data of two groups were determined and compared. Results In control group, cardiac output [（3.34±1.09） L/min], cardiac index [（2.06 ± 0.46） L/ （min·m2）], stroke volume [（41.89 ± 13.72） ml], stroke index[（25.59 ± 7.32） ml/m2], accelerate cardiac index [（59.24 ± 28.41） L/100 s2], left cardiac work index [（2.09 ± 0.67） （kg·m）/m2], left ventricular ejection time[（254.32 ± 27.34） ms], ejection fraction （0.37 ±0.03） and velocity index [（27.11 ± 11.32） L/100 s] were all significantly lower than those in test group [（4.12 ± 1.06） L/min, （2.64 ± 0.48） L/ （min·m2）, （46.21 ± 11.81） ml, （28.87 ± 5.32） ml/m2, （79.43 ±29.01） L/100 s2, （3.21 ± 0.84）（kg·m）/m2, （281.29 ± 29.11） ms,0.54 ±0.04, （39.34 ± 12.11） L/100 s,respectively] （P 〈 0.01）; pre-ejectionphase [（116.54 ± 22.37） ms] and systolic time ratio （0.48 ± 0.04） were significantly higher than those in test group[（95.24 ± 21.41） ms,0.36 ± 0.02,respectively] （P 〈 0.01 or 〈0.05）. Conclusion Non-invasive hemodynamic monitor system is helpful in the early differential diagnosis of SAP combined with pulmonary edema.