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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。
Objective: To investigate the guiding significance of continuous cardiac output monitoring by pulmonary thermodilution pulse wave (PiCCO) in patients with acute inferior myocardial infarction. Methods: Twenty-six patients with acute inferior myocardial infarction admitted from July 2012 to January 2014 in the Department of Cardiology, PLA General Hospital were treated with PiCCO and echocardiography to monitor cardiac output (CO), cardiac index (CI) And correlation analysis. Results: The CI of PiCCO after PiCCO implantation and 72 hours after PiCCO treatment were (2.77 ± 0.77) L · min-1 · m-2 and (3.17 ± 0.39) L · min-1 · m-2 respectively (2.49 ± 0.64) L · min-1 · m-2 and (2.63 ± 0.24) L · min-1 · m-2, respectively (P <0.01). There was no significant difference between the two groups (P> 0.05). The CO detected by PiCCO was (4.78 ± 1.06) L / min and (5.08 ± 1.53) L / min respectively, with significant difference (P < min and (4.57 ± 0.91) L / min, respectively. There was no significant difference between the two groups (P> 0.05). After PiCCO was administered for 72h, the CI and CO of PiCCO were significantly higher than those of UCG (P <0.01). CONCLUSIONS: The hemodynamic parameters monitored by PiCCO are more sensitive than those of echocardiography, which are of great importance for the treatment of patients with unstable hemodynamically inferior myocardial infarction.