CAJ | 학술논문

目的：探讨经肺热稀释脉波指示连续心排血量监测（PiCCO）在急性下壁心肌梗死患者治疗的指导意义。方法：对解放军总医院心内科监护室2012年7月到2014年1月收治的26例急性下壁心肌梗死患者分别行PiCCO及心脏超声监测心排血量（CO）、心脏指数（CI），并进行相关性分析。结果：PiCCO置入时及置入72h后的PiCCO监测的CI分别为（2.77±0.77）L·min－1·m－2，（3.17±0.39）L·min－1·m－2，有显著差异（P＜0.01），心脏超声测定的CI分别为（2.49±0.64）L·min－1·m－2，（2.63±0.24）L·min－1·m－2，没有显著差异（P＞0.05）；PiCCO监测的CO分别为（4.78±1.06） L／min ，（5.08±1.53） L／min ，有显著差异（ P＜0.05），心脏超声测定的CO分别为（4.51±0.86） L／min ，（ 4.57±0.91） L／min ，没有显著差异（P＞0.05）；PiCCO置入72h后PiCCO测定的CI ，CO显著高于UCG测定的（P均＜0.01）。结论：PiCCO监测的血流动力学指标较心脏超声监测的更为敏感，对于血流动力学不稳定的急性下壁心肌梗死病人的治疗指导有重要意义。
목적：탐토경폐열희석맥파지시련속심배혈량감측（PiCCO）재급성하벽심기경사환자치료적지도의의。방법：대해방군총의원심내과감호실2012년7월도2014년1월수치적26례급성하벽심기경사환자분별행PiCCO급심장초성감측심배혈량（CO）、심장지수（CI），병진행상관성분석。결과：PiCCO치입시급치입72h후적PiCCO감측적CI분별위（2.77±0.77）L·min－1·m－2，（3.17±0.39）L·min－1·m－2，유현저차이（P＜0.01），심장초성측정적CI분별위（2.49±0.64）L·min－1·m－2，（2.63±0.24）L·min－1·m－2，몰유현저차이（P＞0.05）；PiCCO감측적CO분별위（4.78±1.06） L／min ，（5.08±1.53） L／min ，유현저차이（ P＜0.05），심장초성측정적CO분별위（4.51±0.86） L／min ，（ 4.57±0.91） L／min ，몰유현저차이（P＞0.05）；PiCCO치입72h후PiCCO측정적CI ，CO현저고우UCG측정적（P균＜0.01）。결론：PiCCO감측적혈류동역학지표교심장초성감측적경위민감，대우혈류동역학불은정적급성하벽심기경사병인적치료지도유중요의의。
Objective:To explore the guiding significance of transpulmonary thermodilution pulse‐indicated continu‐ous cardiac output (PiCCO) in treatment for patients with acute inferior wall myocardial infarction (AIMI) .Meth‐ods:A total of 26 AIMI patients in intensive care unit of cardiology department in our hospital from Jul 2012 to Jan 2014 received PiCCO and ultrasonic cardiography (UCG) to monitor cardiac output (CO) and cardiac index (CI) , and their correlation analysis .Results:When PiCCO placement and after placement 72h ,PiCCO monitoring CI were (2.77 ± 0.77) L · min-1 · m-2 , ( 3.17 ± 0.39) L · min-1 · m-2 respectively ,there was significant difference (P<0.01) ,UCG measured CI were (2.49 ± 0.64) L · min-1 · m-2 , ( 2.63 ± 0.24) L · min-1 · m-2 , there was no significant difference (P>0.05);PiCCO monitoring CO were (4.78 ± 1.06) L/min , ( 5.08 ± 1.53) L/min re‐spectively ,there was significant difference (P<0.05) ,UCG measured CO were (4.51 ± 0.86) L/min , ( 4.57 ± 0.91) L/min ,there was no significant difference ( P>0.05);and CI , CO measured by PiCCO were significantly higher than those of UCG group (P<0.01 both) after PiCCO placement 72h .Conclusion:Pulse‐indicated continu‐ous cardiac output can offer more sensitive hemodynamic indexes compared with UCG ,which possesses important treatment guiding significance in patients with acute inferior wall myocardial infarction and unstable hemodynamics .