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目的探讨无创血流动力学监测系统评价硫酸镁治疗重度子痫前期患者的效果。方法用Biozcom数字化无创血流动力学监测系统监测100例妊娠晚期孕妇,其中重度子痫前期55例为观察组,健康孕妇45例为对照组,并选取其中8项进行记录分析:心率(HR)、平均动脉压(MAP)、心脏指数(CI)、心排血量(CO)、外周血管阻力指数(SVRI)、外周血管阻力(SVR)、胸液水平(TFC)、左心做功指数(LCWI),同时监测55例观察组患者用25%硫酸镁20 ml(5 g)作为首剂负荷量后,即用药30 min后血流动力学变化,分析各项参数与临床征象的关系。结果 (1)与对照组孕妇比较,观察组患者MAP、SVRI、SVR、TFC显著增高,CI、CO显著降低,差异有统计学意义(t=-11.60、-8.86、3.07、-7.16,2.47、2.52,P<0.01),HR、LCWI差异无统计学意义(t=0.52、-1.04,P>0.05)。(2)观察组患者硫酸镁5 g首剂治疗后MAP、SVRI、SVR较治疗前有所下降,CI、CO较治疗前有所增高,差异有统计学意义(t=8.82、7.89、13.45、-2.97、-9.65,P<0.05),HR、TFC、LCWI差异无统计学意义(t=-0.68、0.77、-1.12,P>0.05)。结论重度子痫前期时,使用硫酸镁能显著降低孕妇血管外周阻力及血压,增加心输出量,对心率、左心做功影响不明显,无创血流动力学监测系统临床使用方便,重复性好,能连续观察病情变化,具有较强的实用价值。
Objective To evaluate the efficacy of noninvasive hemodynamic monitoring system in the evaluation of magnesium sulfate in patients with severe preeclampsia. Methods 100 cases of pregnant women in the third trimester of pregnancy were monitored by Biozcom digital noninvasive hemodynamic monitoring system. Among them, 55 cases of severe preeclampsia were observed, and 45 cases of healthy pregnant women as control group. Eight of them were selected for record analysis: heart rate (HR) MAP, CI, CO, SVRI, SVR, TFC, LCWI (left ventricular ejection fraction) ), While monitoring 55 patients in the observation group with 25% magnesium sulfate 20 ml (5 g) as the first dose after 30 min of medication hemodynamic changes, analysis of the relationship between the parameters and clinical signs. Results (1) The MAP, SVRI, SVR and TFC in the observation group were significantly higher than those in the control group (P <0.05). The CI and CO levels were significantly lower in the observation group (t = -11.60, -8.86,3.07, -7.16 and 2.47, 2.52, P <0.01). There was no significant difference between HR and LCWI (t = 0.52, -1.04, P> 0.05). (2) MAP, SVRI and SVR in the observation group were significantly lower than those before treatment after treatment with the first dose of 5 g magnesium sulfate. CI and CO levels were significantly higher than those before treatment (t = 8.82, 7.89, 13.45, -2.97, -9.65, P <0.05). There was no significant difference between HR, TFC and LCWI (t = -0.68,0.77, -1.12, P> 0.05). Conclusion In severe preeclampsia, the use of magnesium sulfate can significantly reduce peripheral vascular resistance and blood pressure in pregnant women, increase cardiac output, heart rate, left ventricular dysfunction is not obvious, noninvasive hemodynamic monitoring system is easy to use, reproducible, Continuous observation of changes in condition, with strong practical value.