胸阻抗法测量心脏指数和射血分数的临床研究

Clinical investigation of measurement of cardiac index and ejection fraction index by means of thoracic impendance method

目的评价胸阻抗法测量心脏指数和左心射血分数两项指标的准确性及临床应用价值。方法６５位成人非瓣膜病患者，同时用彩色超声和胸阻抗法测量左心射血分数（ＥＦ）值； ６位非胸部手术后的危重病患者，在用 Ｓｗａｎ－ Ｇａｎｚ导管测量心脏指数的同时，用胸阻抗法测量心脏指数，每位患者取１０对数据。结果胸阻抗法测量的左心ＥＦ值为５７．４±５．９％，彩色超声同时测量的ＥＦ值为６３．５±８．８％，ｔ检验两种方法测量的结果无统计差异（Ｐ＞０．０５），两种测量方法的结果无相关性（ ｒ＝ ０．０４）； Ｓｗａｎ－ Ｇａｎｚ导管与胸阻抗法的对照结果说明，两种测量方法的结果有较好的相关性（１例ｒ＝ ０．６９３，其余５例ｒ≥０．８００），平均相关性ｒ＝０．８５６。结论胸阻抗法测量左心射血分数的结果不适合用作临床指标；胸阻抗法可用于连续监测患者的心脏指数。建议这种监测是在胸阻抗不受其它因素明显影响的情况下进行，如：机械通气的条件改变或大量补液等。

Objective To evaluate the accuracy and clinical use of cardiac index and ejection fraction derived horn transthoraccic electrical bioimpedance (TEB). Methods Sixty - five adult non - valvular disease patients were examined with TEB and color doppler simultaneously, coupled EF values derived from each method were compared ;6 non - chest - operation patients were examined with TEB and Swan - Ganz for cardiac index(CI), 10 couples of Cls were derived from each patient. Results The left ventricular EF derived from TEB and ultrasonic methods were 57. 4 ± 5. 9% and 63. 5± 8. 8% respectively, the results were poor related, r = 0 .04. Cis derived from Swan - Ganz catheters and TEB are closely related r = 0. 856. Conclusions The hioimpedance method was not suitable for examination of EF, but this method can be used to monitor the cardiac performace continuously and the results can accurately respctively changes of patient's circulations.