CAJ | 학술논문

目的探讨连续性静脉-静脉血液滤过(CVVH)治疗对使用脉搏指示连续心排血量(PiCCO)监测仪测得的血流动力学监测指标心脏指数(CI)、全心舒张末期容积指数(GEDI)、血管外肺水指数(ELWI)的影响.方法选择北京医院重症监护病房(ICU)收治的并发急性肾衰竭的危重症老年患者12例,使用PiCCO监测仪对实施CVVH治疗的患者进行血流动力学监测,每例患者分别在暂停血滤期间及血滤进行中进行检测,并记录所测得数据.采用配对双侧t检验比较暂停血滤期间及血滤进行中两组CI、GEDI、ELWI的差异.结果患者12例,共获取数据48组.测得暂停血滤期间及血滤进行中CI的平均值分别为(4.75±0.93)L·min(-1)·m(-2)及(4.69±0.89)L·min(-1)·m(-2),GEDI的平均值分别为(780.60±109.30)ml/m2及(784.75±106.20)ml/m2,ELWI的平均值分别为(11.61±3.45)ml/kg及(11.54±3.56)ml/kg,经配对t检验差异无统计学意义(P>0.05).结论 CVVH不影响PiCCO血流动力学监测指标CI、GEDI、ELWI的准确性和可靠性.
목적 탐토련속성정맥-정맥혈액려과(CVVH)치료대사용맥박지시련속심배혈량(PiCCO)감측의측득적혈류동역학감측지표심장지수(CI)、전심서장말기용적지수(GEDI)、혈관외폐수지수(ELWI)적영향.방법 선택북경의원중증감호병방(ICU)수치적병발급성신쇠갈적위중증노년환자12례,사용PiCCO감측의대실시CVVH치료적환자진행혈류동역학감측,매례환자분별재잠정혈려기간급혈려진행중진행검측,병기록소측득수거.채용배대쌍측t검험비교잠정혈려기간급혈려진행중량조CI、GEDI、ELWI적차이.결과 환자12례,공획취수거48조.측득잠정혈려기간급혈려진행중CI적평균치분별위(4.75±0.93)L·min(-1)·m(-2)급(4.69±0.89)L·min(-1)·m(-2),GEDI적평균치분별위(780.60±109.30)ml/m2급(784.75±106.20)ml/m2,ELWI적평균치분별위(11.61±3.45)ml/kg급(11.54±3.56)ml/kg,경배대t검험차이무통계학의의(P>0.05).결론 CVVH불영향PiCCO혈류동역학감측지표CI、GEDI、ELWI적준학성화가고성.
Objective To explore the influence of continuous veno-venous hemofiltration (CVVH) therapy on cardiac index (CD, global end-diastolic volume index (GEDI) and extravascular lung water index (ELWI) monitored by Pulse-indicated continuous cardiac output (PiCCO). Methods The 12 critically ill patients with acute renal failure were selected consecutively from department of intensive care unit (ICU) in Beijing Hospital. The patients who received CVVH therapy were monitored by PiCCO plus device. The hemodynamic measurements were performed during the process and interruption of CVVH. Pared t-test was used to analyze the values of CI, GEDI and ELWI. Results A total of 48 groups of data from 12 patients were analyzed. There were no significant differences in CI [(4.75±0.93) L ? min(-1) · m(-2)vs. (4.69±0.89) L · min(-1) · m(-2)], GEDI [(780.60±109.30) ml/m2 vs. (784.75± 106.20) ml/m2] and ELWI CC11.61±3.45) ml/kg vs. (11.54±3.56) ml/kg] between the interruption and process of CVVH, as obtained by the pared t-test (all P>0.05). Conclusions The CVVH therapy has no effect on the accuracy and reliability of PiCCO measurement of CI, GEDI and ELWI.