摘要
目的比较Swan-Ganz导管、PiCCO导管和彩色多普勒超声测量心脏前负荷的准确性和灵敏度。方法通过动物实验,依次行彩色多普勒超声法测定左室舒张末期容积(LVEDV)、Swan-Ganz导管法测定肺小动脉楔压(PCWP)和PiCCO导管法测定胸腔内血容量(ITBV),并观察呼气末正压(PEEP)、血管活性药物和血容量快速变化时,上述指标相对于基础值的变化,对比研究其反映心脏前负荷的正确性与灵敏性。结果与基础值相比,在PEEP增高至10cmH2O时,CVP、PCWP增高(P<0.05);血管活性药可以增高CVP值(P<0.05),但不影响PCWP、LVEDV和ITBV;在血容量快速变化时,PCWP、LVEDV和ITBV产生相应的具有统计学意义的变化,而CVP的变化不明显。结论相较经典的Swan-Ganz导管和无创的超声法,PiCCO导管法测量心脏前负荷结果可信,创伤小且具可重复性,值得推广。
Objective To investigate the accuracy and the sensitivity of the multiple indicator from the Swan-Ganz catheter,PiCCO catheter and color doppler ultrasonic assessment of the cardiac preload.Methods Measured the left ventricular end-diastolic volume by the color doppler ultrasonography;Pulmonary capllary wedge pressure by the Swan-Ganz catheter;Intrathoracic blood volume by the PiCCO catheter in eighteen pigs successively and analysis the data and contrast it with the basic figure when add the PEEP,vasoactive drugs and change the blood volume rapidly.Results Comparison with the basic figure,the higher CVP and PCWP were observed in 10cmH2O level PEEP （P0.05）;CVP could be improved significantly when used the vasoactive drugs （P0.05）;PCWP,LVEDV and ITBV could be improved significantly when changed the blood volume fastly （P 0.05）.Conclusion In contrast with classic method as the Swan-Ganz catheter and the noninvasive ultrasonic examination,PiCCO catheter possess superiority because it can give us the effective datum of hemodynamics with minimum damage and its result is believable and can be duplicated.
出处
《中国现代医药杂志》
2010年第2期4-7,共4页
Modern Medicine Journal of China
基金
江苏省苏州市科技发展计划项目(SZD0437)
