摘要
目的 对急诊感染性休克患者同时进行脉搏波形指示的连续心输出量（pulse indicated continuous cardiac output, PiCCO）监测技术和无创超声心输出量测定,以有创血流动力学监测的数值作为标准,对无创超声心输出量测定方法的可靠性进行评价.方法 本试验为前瞻性研究,2008-06～2009-06北京协和医院急诊科抢救室和EICU收治32例明确诊断为感染性休克的患者,对这些患者同时进行无创超声心输出量测定和PiCCO监测,对比两者在心脏指数（cardiac index, CI）这一血流动力学核心指标上的差异,以评价无创超声心输出量测定在急诊应用中的可靠性.结果 共有30例患者同时获得了满意的血流超声多普勒影像,其中男性20例,女性10例,最小年龄26岁,最大年龄89岁,另2例患者因无法获得满意的超声结果而放弃.对比结果显示,在获得满意超声多普勒影像的前提下,无创超声心输出量和PiCCO测定的CI分别为（3.89±1.61）L/（min·m^2）和（4.35±1.72）L/（min·m^2）（Pearson相关系数＝0.97165,P〈0.0001）.结论 无创超声心输出量测定是一项准确、快速、安全、无创的血流动力学监测技术,比较适合急诊患者的应用.
Objective The USCOM ultrasonic cardiac output monitor （USCOM Pty Lid, Coifs Harbour, NSW, Australia） is a non- invasive device that determines cardiac output by continuous- wave Doppler ultrasound. The aim of this study was to evaluate the accuracy of the USCOM device compared with the PiCCO （ pulse indicated continuous cardiac output ） technique on the septic shock patients in Emergency Room and Emergency Intensive Care Unit in Peking Union Medical College Hospital. Methods We conducted a prospective study in Emergency Room and Emergency Intensive Care Unit in Peking Union Medical College Hospital from June 1st, 2008 to May 31st, 2009. Thirty - two patients who were diagnosed as septic shock were recruited in this study. We evaluated the USCOM monitor by comparing its cardiac index with paired measurements obtained by the PiCCO technique. Results Among the 32 patients, thirty paired measurements were obtained. Another 2 patients were excluded because we couldn ＇t get an acceptable signal. Comparison of the two techniques showed CIuscom （cardiac output by USCOM ） and CIpicco （cardiac output by PiCCO） were separately （3.89 ± 1.61 ） L/（ min· m^2 ） and （ 4. 35 ± 1.72 ） L/（ min· m^2 ） （ Pearson correlation = 0. 97165, P 〈 0. 0001 ）. Conclusion The USCOM monitor has a place in Emergency Department because of its accurate, rapid, safe, well - tolerated, non - invasive and cost - effective advantages.
出处
《中国急救医学》
CAS
CSCD
北大核心
2011年第3期193-196,289,共5页
Chinese Journal of Critical Care Medicine
