无创血流动力学监测系统在ICU的综合应用分析

Application and analysis of hurtless hemodynamic measure system in ICU

目的 探讨无创血流动力学监测系统在ICU的综合应用价值。方法 选取我院2003年7月初～2003年11月底收治于综合ICU的急危重病人、术后复苏病人、应用呼吸机通气病人共215例,总结分析Bioz.com无创血流动力学监测系统应用情况,研究选择有代表性的CO(心排血量)、TFC(胸液成分)、ACI(心肌加速度指数)、SVR(外周血管阻力)做统计学分析。结果 1. 全麻后复苏组各参数值均接近正常参考值(p>0.05)。2. 不同的PSV对各参数的影响不显著(p>0.05),但不同PEEP值对ACI、SVR参数的影响显著(p<0.01)。3. GCS评分<8组各参数三日中有显著变动(p<0.05),8分及以上组各参数波动不显著(p>0.05)。4. 心衰病人组用药前后各参数有显著差异(p<0.001)。结论 Bioz.com系统有无创、连续、操作简便、高精确性、性价比高、极强的抗干扰能力的特点,可在大多数情况下替代有创血流动力学监测方法,在综合ICU中广泛应用,但要注意电阻抗弱的时候,结果有可能不可靠。

Objective To explore the comprehensive application value of hurtless hemodynamic measuresystem in ICU. Methods 215 cases of acute and severe patients, post-operation resuscitation patientsand the patients who were receiving mechanical ventilation were treated in comprehensive ICU from July2003 to November 2003. The application condition of hurtles hemodynamic measure system was analyzed, andthe cardiac output (CO), thoracic fluid content (TFC), acceleration cardiac index (ACI) and systemicvascular resistance (SVR) were analyzed statisticly. Results ① There was no difference between allparameters in resuscitation patients after general anesthesia and normal reference values (P>0.05). ②The effect of different PSV was not obvious for all parameters (P>0.05), but ACI and SVR the effect ofdifferent PEEP values was obvious for all parameters (P<0.01). ③ The change of all parameters wassignificant in lower Glasgow coma scales group in three days (GCS<8)(P<0.05), then the change was notsignificant in higher GCS group (GCS>8)(P>0.05). ④ The change of all parameters was significant beforeand after medication in heart failure group (P<0.01). Conclusion The Bioz.com system has many feature,such as hurtles, continue, simple, accurate, high performance/price ratio and strong anti-interferencecapability,it can replace the invasive hemohynamic measure method in most cases and be used widely incomprehensive ICU. However, the result may be uncertain when the electrical impedance is weak.