摘要
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 explore noninvasive hemodynamic monitoring system in evaluating the effect of magnesium sulfate in treatment of patients with severe preeclampsia. Methods A total of 100 pregnant women in late pregnancy were monitored by Birzcom digital noninvasive hemodynamic monitoring system. Among these cases, there were 55 pregnant women with severe preeclampsia in observation group and 45 healthy pregnant women in control group. Eight of the parameters were selected for record and analysis： heart rate （ HR ） , mean arterial pressure （MAP）, cardiac index （CI）, cardiac output （CO）, systemic vascular resistance index （SVRI）, systemic vascular resistance （SVR）, thoracic fluid content （TFC）, left cardiac work index （LCWI） . After using 20 ml magnesium sulfate （25%, 5 g） as the first dose, the hemodynamic changes after 30 minutes in observation group were monitored. The relationships between parameters and clinical signs were analyzed. Results Compared with control group, MAP, SVRI, SVR, and TFC in observation group increased, while CI and CO reduced, there were statistically significant differences （t=-11. 60, P〈0. 01 ; t=-8.86, P〈0. 01 ; t=3.07, P〈0. 01 ; t=-7.16, P〈0. 01; t=2.47, P〈0. 01; t = 2. 52, P〈0. 01 ）, but there was no statistically significant difference in HR and LCWI between the two groups （t = 0. 52, -1.04, P〉0. 05 ） . In observation group, after treated by magnesium sulfate, MAP, SVRI, and SVR decreased compared with before treatment, CI and CO increased compared with before treatment, there were statistically significant differences （t = 8.82, 7.89, 13.45, -2. 97, -9. 65, P〈 0. 05） , but there was no statistically significant difference in HR, TFC, and LCWI （t=-0. 68, 0. 77, -1. 12, P〉0.05） . Conclusion Magnesium sulfate used for severe preeclampsia patients can significantly reduce maternal peripheral vascular resistance and blood pressure and increase cardiac output, but it has no significant effect on heart rate and left ventricular function. Noninvasive hemodynamie monitoring system is easy and reproducible for clinical use, and it can continuously monitor patients＇ conditions, so it has great practical value.
出处
《中国妇幼保健》
CAS
2017年第19期4841-4843,共3页
Maternal and Child Health Care of China
基金
甘肃省科学技术厅医药卫生科技项目(1606RJZA169)
关键词
硫酸镁
重度子痫前期
无创血流动力学监测
Magnesium sulfate
Severe preeclampsia
Noninvasive hemodynamic monitoring
