急性胰腺炎血流动力学特点及监测手段的研究进展

Research Progress of Hemodynamic Characteristics and Monitoring Methods in Acute Pancreatitis

急性胰腺炎(AP)是一种急性炎症性疾病,以急性腹痛和血清淀粉酶的升高为主要临床表现。AP患者的血流动力学改变发生在AP的各个阶段,表现为高心脏指数、显著的肺分流、外周血管阻力以及心肌收缩力降低,这些改变可能与AP患者低血容量、电解质紊乱以及失调的炎症反应密切相关。监测患者的容量状态对于治疗有指导价值,可降低患者的病死率。常用的监测手段有脉搏指数连续心排血量监测、床旁超声等,反映微循环灌注状态的指标也可用于监测。

Acute pancreatitis(AP)is an acute inflammatory disease characterized by acute abdominal pain and eleva-ted serum amylase.Hemodynamic changes exist in all the stage of AP,which manifest as high cardiac index,significant pulmonary shunt,reduction of systemic vascular resistance and decrease of myocardial contraction force.They may be related with hypovolemia,electrolyte disturbance and disordered inflammation.Monitoring the volume status of patients has guiding value for treatment and can reduce the mortality.Pulse index continuous cardiac output and bedside ultrasound are the useful tools for monitoring and the parameters that reflect microcirculation perfusion can also be used for monitoring.