【摘要】 目的:比较不同浓度去甲肾上腺素对压力记录分析法(PRAM)、动脉轮廓波形分析法(Vigileo system)与脉搏轮廓连续心排量监测(PiCCO)测量血流动力学参数的影响。方法:选取72例外科术后患者,其中36例(A组)应用去甲肾上腺素持续静脉泵入,速度≥0.5μg/kg/min;36例(B组)患者未应用去甲肾上腺素或应用去甲肾上腺素泵入(速度<0.5μg/kg/min),分别通过PRAM、Vigileo及PiCCO测量其每搏输出量(SV)、平均动脉压(MAP)、全身血管阻力指数(SVRI),并分析结果的一致性。结果 :A组经3种方式测得SV分别为(61.31±6.89)ml、(62.72±7.89)ml及(46.08±5.38)ml,除PRAM组与Vigileo system组之间无显著性差异(P>0.05)外,其余两组间比较均有显著性差异(均P<0.05)。A组经3种方式测得的MAP及SVRI,两两比较均无统计学差异(均P>0.05)。B组经3种方式测得的SV、MAP及SVRI,两两比较均无统计学差异(均P>0.05)。结论 :对于未应用去甲肾上腺素或应用去甲肾上腺素持续静脉泵入速度<0.5μg/kg/min的患者,PRAM、Vigileo与PiCCO测得血流动力学参数具有良好的一致性。但应用去甲肾上腺素持续静脉泵入速度≥0.5μg/kg/min的患者,PRAM与Vigileo system对SV的测量不够准确。更多还原

【Abstract】 Objective:To observe and compare the monitoring results of hemodynamic parameters in different concentration of norepinephrine by pressure recording analytical method(PRAM),Vigileo system and classical approach.Methods:Seventy-two patients undergoing surgery were selected randomly.Thirty-six patients(group A)were pumped norepinephrine(≥0.5μg/kg/min).Other thirty-six patients(group B)weren’t pumped norepinephrine or pumped norepinephrine(<0.5μg/kg/min).Stroke volume(SV),mean arterial pressure(MAP) and systemic vascular resistance index(SVRI) were monitored by PRAM,Vigileo system and classical approach,respectively.Results:The SV measured by the three methods were(61.31±6.89)ml,(62.72±7.89)ml and(46.08±5.38)ml in group A.The value measured by PRAM and Vigileo system were significantly higher than that with PiCCO mehtod(P<0.05).The MAP and SVRI measured by the three methods had no statistical significances(all P >0.05).For the patients in group B,the SV,MAP and SVRI which were measured by the three different methods had no statistical significances(all P>0.05).Conclusion:There is much agreement between the measurements of hemodynamic parameters by PRAM,Vigileo system and PiCCO for the patients who weren’t pumped norepinephrine or pumped norepinephrine(<0.5μg/kg/min).But there isn’t accurate enough to the measurement of SV by PRAM,Vigileo system for the patients who were pumped norepinephrine(≥0.5μg/kg/min).更多还原