摘要
目的探讨重症感染患者的血流动力学变化特点,为预测病情和指导治疗提供理论依据。方法选择2009年3月-2013年9月收治的77例急性脓毒血症患者(试验组)和50名健康体检人员(对照组)作为研究对象;通过微创阻抗法监测急性脓毒血症重症感染患者的血流动力学变化,观察检测相关并发症的发生,比较分析两组检测数据,并分层分析病情严重程度与血流动力学检测结果的关系。结果试验组重症感染患者心率(HR)、心脏指数(CI)均较对照组患者显著增加,两组比较差异有统计学意义(P<0.05);重症感染患者SIRS评分为4分的患者与评分为2分和3分比较,表现为HR、CI和左心做功量(LCW)显著增加,差异有统计学意义(P<0.05),体循环阻力指数(SVRI)显著降低(P<0.05);未发现不同年龄组血流动力学参数的明显变化;且两组均未发生与检测相关并发症。结论重症感染患者血流动力学检测结果表现为在不同病情严重程度,随病情逐渐严重而表现为趋于明显增加或降低,因而血流动力学微创检测方法,可成为预测重症感染患者病情发展变化的重要手段。
OBJECTIVE To investigate the characteristics of hemodynamic changes in patients with severe infections ,and to provide theoretical basis for predicting illness and guiding treatment .METHODS Totally 77 patients with acute septicopyemia （test group） and 50 healthy people （control group） during Mar .2009 to Sep . 2013 were enrolled .The minimally invasive impedance detection method was adopted to monitor hemodynamic changes in the patients ,and the relevant complications were observed ,and the testing data of two groups were compared to conduct a hierarchical analysis of the relationship between disease severity and hemodynamic detection results .RESULTS Compared with the control group ,the heart rate （HR） and the cardiac index （CI） in the test group were significantly increased （P〈0 .05） .Compared to patients with SIRS of 2 or 3 points ,the HP ,CI and left cardiac work （LCW） was significantly increased in severe infected patients with SIRS of 4 points （P〈0 .05） , and their systemic vascular resistance index （SVRI） was also significantly reduced （P〈0 .05） .Significant changes of hemodynamic parameters in different age groups were not found .Complications related with the tests were not found in both groups .CONCLUSION According to the hemodynamic test of severe infected patients ,the levels of severity ,the hemodynamics of patients tended to significantly increase or reduce along the aggravation of illness at each level of severity .Therefore the hemodynamic minimally invasive detection method may serve as a forecasting for the development and changes of illness in patient with severe infection .
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2015年第12期2731-2733,共3页
Chinese Journal of Nosocomiology
基金
广东省医学科研基金资助项目(A2013717)
关键词
脓毒血症
血流动力学
心脏指数
体循环阻力指数
Septicopyemia
Hemodynamics
Cardiac index
Systemic vascular resistance index
