标题：无创心脏血流动力监测仪在 ICU危重病患者中的应用

      作者：陈维生，黄东伟，曾景，邓荣华，邓国鹏，陈伟花，邹云良    (惠州市第三人民医院EICU，广州医科大学附属惠州医院，广东 惠州 516001)

      卷次： 2018年29卷15期

      【摘要】 目的 评价无创心脏血流动力监测仪对 ICU危重病患者心功能测定的有效性。方法 选择2016年12月至2017年8月在惠州市第三人民医院急诊重症监护室(EICU)接受治疗并进行无创心脏血流动力监测的40例危重病患者，在行床旁超声心动图检查后立即应用无创心脏血流动力监测仪行心功能测定，监测每搏输出量(SV)、心输出量(CO)和左室射血分数(LVEF)等指标，采用Pearson相关分析评价两种仪器测定结果的相关性。结果 无创心脏血流动力监测仪测定的SV、CO及LVEF分别为(51.73±15.49) mL、(4.27±1.34) L/min、(57.05±11.29)%，床旁超声心动图测定的SV、CO及LVEF分别为(44.01±17.05) mL、(3.67±1.46) L/min、(54.88±13.76)%。两种仪器测定的SV、CO及LVEF经Pearson相关分析均呈正相关(r分别为0.725、0.761、0.448，P<0.01)，排除心律失常患者后的两种仪器测定的SV、CO及LVEF经Pearson相关分析也呈正相关(r分别为 0.875、0.869、0.691，P<0.01)。结论 基于生物阻抗法的无创心脏血流动力监测仪可有效地用于 ICU危重病患者评价心功能，其监测的SV、CO及LVEF与床旁超声心动图测定的结果具有较好的临床一致性，可反映患者的心功能。
      【关键词】 无创心脏血流动力监测仪；重症监护室；心功能监测；每搏输出量；心输出量；左室射血分数
      【中图分类号】 R541 【文献标识码】 A 【文章编号】 1003—6350（2018）15—2085—03

Application of noninvasive cardiac hemodynamic monitor for ICU critically ill patients.
CHEN Wei-sheng, HUANGDong-wei, ZENG Jing, DENG Rong-hua, DENG Guo-peng, CHEN Wei-hua, ZOU Yun-liang. The Third People's Hospital ofHuizhou City, Huizhou Affiliated Hospital of Guangzhou Medical University, Huizhou 516001, Guangdong, CHINA
【Abstract】 Objective To evaluate the effectiveness of noninvasive cardiac hemodynamic monitor for measur-ing cardiac function of critically ill patients in ICU. Methods Forty critically ill patients who were treated and under-went noninvasive cardiac hemodynamic monitoring in the Emergency Intensive Care Unit (EICU) of the Third People'sHospital of Huizhou city during December 2016 and August 2017 were selected in this study. Immediately after bedsideechocardiography, the noninvasive cardiac hemodynamic monitoring was performed to measure cardiac function, includ-ing monitoring stroke volume (SV), cardiac output (CO), and left ventricular ejection fraction (LVEF). Pearson correla-tion analysis was used to evaluate the correlation between the results of two instruments. Results The SV, CO andLVEF were (51.73±15.49) mL, (4.27±1.34) L/min and (57.05±11.29)%, respectively, measured by the noninvasive cardi-ac hemodynamic monitor, and (44.01±17.05) mL, (3.67±1.46) L/min, (54.88±13.76)%, respectively, measured by bed-side echocardiography. The relevant values (SV, CO and LVEF) measured by two instruments were positively correlatedby Pearson correlation (r=0.725, 0.761, 0.448, respectively, P<0.01). After excluding patients with arrhythmia, SV, CO,and LVEF measured by the two instruments were also positively correlated by Pearson correlation analysis (r=0.875,0.869, 0.691, respectively, P<0.01). Conclusion Noninvasive cardiac hemodynamic monitor based on biological im-pedance method can be effectively used for ICU critically ill patients to evaluate the cardiac function. The monitoring re-sults of SV, CO and LVEF have good clinical consistency with the results of bedside echocardiography and can reflectthe cardiac function of patients.
      【Key words】 Noninvasive cardiac hemodynamic monitor; Intensive Care Unit; Cardiac function monitoring;Stroke volume; Cardiac output; Left ventricular ejection fraction·论 著·doi:10.3969/j.issn.1003-6350.2018.15.004基金项目：广东省惠州市科技计划项目(编号：2017Y158)