摘要
目的观察经不同位置注射冷盐水对脉搏指示连续心排血量（PiCCO）经肺热稀释参数的影响。方法选择健康杂种绵羊10只，分别经右侧颈外静脉置人Swan—Ganz导管，经左颈外静脉逆行置人中心静脉导管，并于股动脉置人PiCCO热稀释导管。根据冷盐水注射部位的不同分为Swan-Ganz导管静脉端注射对照组（A组）、左侧逆行颈外静脉导管注射组（B组）、Swan—Ganz导管鞘管注射组（C组）、Swan—Ganz导管肺动脉端注射组（D组）。在10min内，分别自上述4个注射点注射冷盐水，由股动脉置入的PiCCO导管获得热稀释参数、记录各组所测得的平均动脉压（MAP）、心排血量（CO）、全心舒张末期容积（GEDV）、血管外肺水指数（EVLWI）等参数；记录经肺热稀释曲线获得的平均传输时间（MTt）、下降时间（DSt）和曲线下面积（AUC）。结果①4组MAP、CO和EVLWI比较差异均无统计学意义（均P〉0．05）。②GEDV：B组较A组明显升高（mL：737．96±321．63比645．53±234．46，P〈0．05），且为4组最高；C组高于A组、低于B组，但分别与两组比较差异均无统计学意义（mL：687．33±298．55比645．53±234．46、737．96±321．63，均P〉0．05）；D组较A组明显降低（mL：493．33±254．65比645．53±234．46，P〈0．05），且为4组最低。③DSt、AUC和MTt：4组DSt和AUC比较差异无统计学意义（均P〉0．05）；B组MTt较A组明显升高（s：46．26±16．64比43．91±16．93，P〈0．05），且为4组最高；C组Mrrf高于A组、低于B组，但分别与A、B两组比较差异均无统计学意义（S：45．92±16．87比43．91±16．93、46．26±16．64，均P〉0．05）；D组MTt较A组明显降低（S：40．22±15．77比43．91±16．93），且为4组最低。结论经不同部位冷盐水注射可能对经肺热稀释参数造成一定的影响，临床上应予以关注。
Objective To investigate the influence of differential sites for cold saline injection on transpulmonary thermodilution parameters of pulse-indicated continuous cardiac output （PiCCO）. Methods Ten healthy hybrid sheep were selected for the study. Swan-Ganz catheter was inserted into the right external jugular vein, the center venous catheter was retrogradely inserted into the left external jugular vein, and PiCCO thermodilution catheter was inserted into femoral artery respectively. According to the different injection sites of cold saline, the sheep were divided into injection site of Swan-Ganz catheter at venous infusion port （VIP） control group （group A）, the left retrograde external jugular vein catheter injection group （group B）, Swan-Ganz catheter sheath canal injection group （group C） and Swan-Ganz catheter pulmonary artery end injection group （group D）. In 10 minutes, the cold saline was injected at the above 4 injection sites respectively, the thermodilution parameter was obtained from the PiCCO catheter inserted into the femoral artery. The mean arterial pressure （MAP）, cardiac output （CO）, global end diastolic volume （GEDV） and extravascular lung water index （EVLWI）, etc. parameters were detected in various group; The mean transmission time （gTt）, downslope time （DSt） and area under curve （AUC） of the transpulmonary thermodilution curve were recorded. Results ① There were no statistically significant differences in MAP, CO and EVLWI （all P 〉 0.05） among the four groups. ② GEDV： The GEDV in group B was significantly higher than that in group A （mL： 737.96 321.63 vs. 645.53 ± 234.46, P 〈 0.05）, and GEDV in group B was the highest in the four groups; GEDV in group C was higher than that in group A, lower than group B, however, there were no statistically significant difference between C and A group and C and B group, respectively （mL： 687.33 ± 298.55 vs. 654.53 ± 234.46, 737.96 ± 321.63, both P 〉 0.05）; the GEDV in group
作者
滕洪云
杨万杰
王伟
冯庆国
高海玲
王玉梅
化宁
Teng Hongyun;Yang Wanfie;Wang Wei;Feng Qingguo;Gao Hailing;Wang Yumei;Hua Ning(Department of Critical Care Medicine,Tianjin Fifth Center Hospital,Tianjin 300450,China)
出处
《中国中西医结合急救杂志》
CAS
CSCD
北大核心
2018年第4期437-440,共4页
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
基金
天津市滨海新区医药卫生科技项目（2012BWKL002）
关键词
注射部位
经肺热稀释
全心舒张末期容积
血管外肺水
Site of injection
Transpulmonary thermodilution
Global end diastolic volume
Extravascular lung water
