重症脑血管病血流动力学监护与预后的关系研究

Hemodynamics Monitor in Severe Cerebral Vascular Disease

目的分析脉搏波形轮廓稳定稀释心排量测量技术(pulse indicator continous cardiac output,Pi CCO)监测血流动力学指标对重症脑血管病死亡率的影响。方法连续纳入重症脑血管病患者,在入院72 h内进行Pi CCO监测,按照发病28 d随访患者是否死亡分为死亡组和存活组,比较2组的基线资料、临床特点、血液生化指标及Pi CCO监测指标。结果入院7 d时死亡组血管外肺水指数(extravascular lung water index,EVLWI)异常增高例数显著高于存活组(P=0.007);而且存活组入院7 d与首次监测时EVLWI的差值也显著小于死亡组(P=0.043)。结论重症脑血管病患者入院后Pi CCO监测EVLWI指标的增高可能与患者死亡有关。

Objective To analyze the effect of the new hemodynamics monitor technique Pulse Indicator Continous Cardiac Output（PiCCO） in the prognosis of severe cerebral vascular disease patients. Methods We consecutively enrolled the severe cerebral vascular disease patients after admission and applied PiCCO monitoring within 72 hours. We compared the baseline, clinical data and PiCCO monitoring result in the survival group and the death group. Results The patients who dead on the 7th day after admission had an abnormally elevating extravascular lung water index（EVLWI） compared with the survival group（P=0.007）, and the difference of the first EVLWI and on the 7th day was significantly lower in the survival group （P=0.043）. Conclusion PiCCO monitoring detected the elevation of EVLWI may indicate the death after admission of the severe cerebral vascular disease patients.