摘要
目的 观察感染性休克患者右心室功能的变化 ,为防治感染性休克患者右心室功能不全进一步提供理论依据。方法 选择急救中心 1997年 10月至 2 0 0 0年 10月 3年间收治的感染性休克患者 36例 ,运用REF 1TM右心功能监测仪和HP监护仪 ,结合超声心动图观察右心室射血分类 (RVEF)、右心室室壁应力 (RVWS)、充盈早期最大流速 (E)与晚期最大流速 (A)之比 (E/A)、充盈早期最大流速减速时间 (Dte)、平均肺动脉压 (mPAP)、肺血管阻力指数(PVRI)、中心静脉压 (CVP)、右心室舒张末容积指数 (RVEDVI)、心排指数 (CI)、肺动脉嵌压(PAWP)、右心室每搏作功指数 (RVSWI)和右心室作功指数 (RCWI)的变化。结果 休克早期患者即出现轻度右心室功能不全 ,表现为RCWI、RVSWI、RVEF、E/A、Dte的下降及RVWS的增加 ;随着休克病情的恶化 ,RCWI、RVSWI、RVEF、E/A、Dte的进一步下降及RVWS的进一步增加 ;而休克纠正后 ,RVEF和RVWS基本恢复正常 ,RCWI、RVSWI、E/A、Dte及RVWS均未见明显改善。结论 感染性休克患者休克早期右心室功能减退 ,晚期出现右心衰竭 ;随着休克的纠正 ,右心室功能有一定程度的改善 。
Objective To evaluate right ventricular dysfunction in patients with septic shock to provide theoretic basis on prevention and treatment of right ventricular dysfunction septic shock.Methods 36 patients who suffered from septic shock were selected in emrgency department from Oct.1997 to Oct.2000. we measured right entricular ejection fraction(RVEF),medium pulmonary arterial pressure(mPAP),central venous pressure(CVP),pulmonary arterial wedge pressure(PAWP),cardiac output index(CI),right ventricular wall stress (RVWS),the rate of peak early inflow velocity(E) and peak late velocity(A),(E/A),deceleration time of E peak(Dte),right cardiac work index(RCWI),right ventricular systolic work index(RVSWI),right entricular end diastolic volume index(RVEDVI),pulmonary vascular resistance index(PVRI) by electrocadiograms and REF1 TM ejection fraction/cardiac output computer.Results There was mild right ventricular dysfunction in patients during early periods of septic shock;with RCWI?RVSWI?RVEF?E/A?Dte decreasing and RVWS increasing.Both become cignificant during late periods of septic shock.After correction of septic shock,there was not much improvement in right ventricular function except RVEF and RVWS teturning to normal levels.Conclusion There was right ventricular dysfunction in patients with septic shock.After recovery of shock,there was degree of improvement of right ventricular function,although not completely to normal level.
出处
《中华急诊医学杂志》
CAS
CSCD
2001年第3期179-181,共3页
Chinese Journal of Emergency Medicine
