重症患者的心功能障碍:病理生理与治疗

Cardiac dysfunction in critical ill patients: pathophysiology and treatment

重症患者常常发生心功能障碍,其病理生理的改变涉及多种机制,包括血流动力学的变化,神经、内分泌因素的作用,炎症反应,心肌损伤和重构。除了心脏本身病变引起心功能异常外,心外器官如肺、肾、脑、胃肠道等发生功能障碍时亦可引起心功能障碍。对于心功能障碍的重症患者,在改善心功能的同时,需维持血流动力学稳定、加强心外器官的功能支持。

Cardiac dysfunction often happens in critical ill patients with multiple pathophysiological mechanisms, including hemodynamic changes, nerve and endocrine factors, inflammatory reaction, myocardial injury and remodeling. Not only heart disease but also dysfunction of extracardiac organs such as lung, kidney, brain, gastrointestinal can lead to cardiac dysfunction. It is essential to enhance the heart function, maintain the hemodynamic stability and strengthen extracardiac organs function support is also important for critical ill patients with cardiac dysfunction at the same time.