血流动力学监测在感染性休克中的应用

Application of hemodynamic monitoring in septic shock

目的探讨血流动力学监测在感染性休克中的应用价值。方法选取2007年1月-2011年5月进行治疗的37例感染性休克患者为研究对象,将其设为观察组,同时选取同期的37名健康体检人员为对照组,将观察组治疗前及治疗后6、12、24、48h的血流动力学指标进行检测及比较。结果观察组治疗前的平均动脉压(MAP)为(36.12±6.56)mm Hg,中心静脉压(CVP)为(3.30±0.31)cm H2O,心脏指数(CI)为(1.79±0.53)L/(min.m2),心搏指数(SI)为(50.45±4.68)ml/m2,对照组的MAP为(76.25±6.40)mm Hg,CVP为(9.52±1.44)cm H2O,CI为(6.12±0.45)L/(min.m2),SI为(15.42±3.69)ml/m2,观察组均低于对照组,差异有统计学意义(P<0.05);经治疗,观察组的上述指标呈现持续升高的趋势,而心率水平则呈现持续降低的趋势,治疗48h时观察组与对照组差异无统计学意义。结论血流动力学监测在感染性休克的发展及转归的诊断中有较高的价值,可在临床中进行监测。

OBJECTIVE To investigate the application value of hemodynamic monitoring in septic shock. METHODS A total of 37 patients with septic shock from Jan.2007 to May 2011 in our hospital were chosen as the research objects in the observation group.Meanwhile,37 volunteers with healthy physical examination were chosen in the control group.The hemodynamic index at 6h,12h,24h and 48h were tested and compared before treatment and after treatment,respectively. RESULTS Before treatment,the mean arterial pressure（MAP）,central venous pressure（CVP）,cardiac index（CI） and stroke index（SI） were（36.12±6.56） mm Hg,（3.30±0.31） cm H2O,（1.79±0.53）L/min·m2 and（50.45±4.68） ml/m2,respectively in observation group,which were lower than（76.25±6.40） mm Hg,（9.52±1.44） cm H2O,（6.12±0.45）L/min·m2,（15.42±3.69） ml/m2 in control group.There were significantly different（P＆lt;0.05）.After treatment,the above index in observation group showed continuous increase tend but the heart rate showed continuous decrease tend.There was no significant difference between the two groups at 48h after treatment（P＆gt;0.05）. CONCLUSION Hemodynamic monitoring has high value in the development and the diagnosis and prognosis of septic shock,and can be applied in the clinical treatment.