无创血流动力学评价在心力衰竭中的应用进展

Application Progress of Noninvasive Hemodynamic Evaluation in Heart Failure

心力衰竭患者可出现不同程度的血流动力学紊乱,有创监测手段准确度高,但有一定局限,难以推广普及。无创监测方法操作简便,几乎无并发症,临床应用前景更加广阔。目前研究较多的无创监测方法包括超声心动图技术、外周血管测定法和阻抗法。超声新技术发展势头良好,但受操作者技术影响较大;外周血管测定法能够测定某一时间点的血流动力学参数,但不能持续监测,且不同原理设备测量结果的准确性差异较大。阻抗法分为胸腔阻抗法和全身阻抗法,能够进行持续性监测,但其准确性与稳定性仍需要进一步研究。更准确、更稳定和可穿戴的持续无创血流动力学监测是未来发展方向。

Patients with heart failure may have varying degrees of hemodynamic disorders. Although with high accuracy, invasive monitoring methods are difficult to popularize because of certain limitations. The noninvasive monitoring methods which are simple to operate, have few complications and a broad clinical application prospect. At present, many non-invasive monitoring methods are studied, such as echocardiography, peripheral blood vessel assay and impedance. The development of new ultrasonic technology has a good momentum, but it may be greatly influenced by operator technology. Peripheral blood vessel assay can determine hemodynamic parameters at a certain point in time, but it can not be used for continuously monitoring, and the accuracy of measurement results of different principle equipment varies greatly. Impedance can be divided into thoracic impedance and whole body bioimpedance, which can carry out continuous monitoring, but it?s accuracy and stability still need to be further studied. More accurate, more stable and wearable continuous non-invasive hemodynamic monitoring is the future development direction.