摘要
目的探讨采用床旁彩色多普勒心动图监测急性心肌梗死并休克患者经皮冠状动脉介入术(PCI)术后心功能的可靠性。方法选择2018年5月至2019年2月在我院行PCI术治疗的48例急性心肌梗死并休克患者,采用脉波指示剂连续心排血量监测患者的全心舒张末期容积指数(GEDI)、心排指数(CI)、每搏量指数(SVI)、全心射血分数(GEF);并应用床旁彩色多普勒心动图监测患者的左室舒张末期容积(LVEDV)、射血分数(EF)、每搏量(SV)、左心排血量(CO)。以脉波指示剂连续心排血量监测结果为金标准,分析床旁彩色多普勒心动图监测患者心功能的准确性。结果脉波指示剂连续心排血量监测结果显示,PCI术后的全心舒张末期容积指数、心排指数、每搏量指数、全心射血分数均显著高于术前(P<0.05);床旁彩色多普勒心动图监测结果显示,PCI术后的左室舒张末期容积、射血分数、每搏量、左心排血量指标明显高于术前(P<0.05)。经Pearson相关性分析发现,床旁彩色多普勒心动图监测的左室舒张末期容积、射血分数、每搏量、左心排血量指标与脉波指示剂连续心排血量监测的全心舒张末期容积指数、心排指数、每搏量指数、全心射血分数水平呈正相关(P<0.05)。结论在重症监护室内采用床旁彩色多普勒心动图监测可反映急性心肌梗死并休克患者PCI术后的心功能,弥补脉波指示剂连续心排血量监测有创、设备条件受限等不足。
Objective To investigate the reliability of bedside color doppler cardiography in monitoring cardiac function after percutaneous coronary intervention(PCI)after acute myocardial infarction and shock.Methods A total of 48 patients with acute myocardial infarction and shock who underwent PCI in our hospital from May 2018 to February 2019 were selected as the research subjects.Global end-diastolic volume index(GEDI),cardiac output index(CI),stroke volume index(SVI)and global ejection fraction(GEF)were measured by pulse indicator continuous cardiac output(PICCO).Left ventricular end-diastolic volume(LVEDV),ejection fraction(EF),stroke volume(SV)and left ventricular output(CO)were monitored by bedside color doppler echocardiography.Using PICCO monitoring results as the gold standard,the accuracy of bedside color doppler cardiography in monitoring cardiac function of patients was analyzed.Results PICCO monitoring results showed that the global end-diastolic volume index,cardiac output index,stroke volume index and global ejection fraction after PCI were significantly higher than those before PCI(P<0.05).The results of bedside color doppler echocardiography showed that the left ventricular end-diastolic volume,ejection fraction,stroke volume and left ventricular output after PCI were significantly higher than those before PCI(P<0.05).Pearson correlation analysis showed that the left ventricular end-diastolic volume,ejection fraction,stroke volume and left ventricular output monitored by bed side Doppler echocardiography were positively correlated with the global end-diastolic volume index,cardiac output index,stroke volume index and global ejection fraction monitored by PICCO(P<0.05).Conclusion The use of bedside color Doppler echocardiography in intensive care unit can reflect the cardiac function of patients with acute myocardial infarction and shock after PCI,and make up for the lack of continuous cardiac output monitoring with pulse wave indicator,such as invasive and limited equipment conditions.
作者
刘兴刚
LIU Xinggang(Guowen Hospital of Jilin,Gongzhuling 136100,China)
出处
《中国医药指南》
2021年第12期54-56,共3页
Guide of China Medicine
关键词
急性心肌梗死
心源性休克
床旁彩色多普勒心动图
经皮冠状动脉介入术
心功能
Acute myocardial infarction
Cardiogenic shock
Bedside color doppler echocardiography
Percutaneous coronary intervention
Cardiac function
