CAJ | 학술논문

目的：探讨无创血流动力学监测对心源性和非心源性急重症患者的诊断及治疗价值。方法选取本院收治的85例急重症患者进行回顾性分析，入选患者均采用无创血流动力学监测，按照病因分为心源性组与非心源性组，比较两组患者无创血流动力学检测参数的差异，并分析该监测方式对治疗的指导意义。结果两组患者的心率(HR)、收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)比较差异均无统计学意义(P>0.05)；心源性组患者心脏指数(CI)、心输出量(CO)每搏输出量(SV)、每搏指数(SI)、左室射血时间(LVET)、加速度指数(ACI)、左室做功(LCW)均显著低于非心源性组(P<0.05)；同时，心源性组患者体血管阻力(SVR)、胸腔液体量(TFC)、收缩时间比率(STR)、预射血期(PEP)显著高于非心源性组(P<0.05)。根据患者病因结合无创血流动力学参数指导治疗，心源性组患者给予强心、利尿等相关治疗，非心源性组给予抗感染、机械通气、改善肾功能等治疗，85例患者存活69例，死亡16例。结论心源性急重症与非心源性急重症的血流动力学指标存在显著差异，可依据监测结果指导早期目标性治疗。
목적：탐토무창혈류동역학감측대심원성화비심원성급중증환자적진단급치료개치。방법선취본원수치적85례급중증환자진행회고성분석，입선환자균채용무창혈류동역학감측，안조병인분위심원성조여비심원성조，비교량조환자무창혈류동역학검측삼수적차이，병분석해감측방식대치료적지도의의。결과량조환자적심솔(HR)、수축압(SBP)、서장압(DBP)、평균동맥압(MAP)비교차이균무통계학의의(P>0.05)；심원성조환자심장지수(CI)、심수출량(CO)매박수출량(SV)、매박지수(SI)、좌실사혈시간(LVET)、가속도지수(ACI)、좌실주공(LCW)균현저저우비심원성조(P<0.05)；동시，심원성조환자체혈관조력(SVR)、흉강액체량(TFC)、수축시간비솔(STR)、예사혈기(PEP)현저고우비심원성조(P<0.05)。근거환자병인결합무창혈류동역학삼수지도치료，심원성조환자급여강심、이뇨등상관치료，비심원성조급여항감염、궤계통기、개선신공능등치료，85례환자존활69례，사망16례。결론심원성급중증여비심원성급중증적혈류동역학지표존재현저차이，가의거감측결과지도조기목표성치료。
Objective To explore the value of noninvasive cardiac output monitoring in diagnosis and treat-ment of acute and critical illness. Methods Eighty-five patients with acute and critical illness were selected in this study retrospectively. All patients received noninvasive cardiac output monitoring. According to the cause of disease, these patients were divided into cardiac symptom group and non-cardiac symptom group. Comparison was made be-tween two groups in respects of noninvasive hemodynamic parameters and its clinical significance in guidance of clini-cal treatment was analyzed. Results There was no difference in HR, SBP, DBP, and MAP between two groups (P>0.05). The CI, CO, SV, LVET, ACI, LCW in cardiac symptom group were lower than those in non-cardiac symptom group (P<0.05). Meanwhile, the SVR, TFC, STR, PEP in cardiac symptom group were higher than those in non-cardi-ac symptom group (P<0.05). After the clinical treatment based on different noninvasive hemodynamic parameters, 69 patients survived and 16 died. Conclusion Cardiac and non-cardiac acute and critical illness differ in hemodynamic parameters, and treatment in early stage is expected under the guidance of monitoring.