PiCCO监测下参附注射液对低排高阻型休克血流动力学的影响

摘要

[目的]通过脉搏指示持续心排血量(pulse indicator continuous cardiac output,PiCCO)监测仪观察参附注射液对低排高阻型休克患者血流动力学参数的作用,探讨其治疗机理.[方法]采用PiCCO进行检测以15例低排高阻型休克患者为研究对象,观察患者在泵入参附注射液前及以10 mL/h的速度持续泵入期间(0.5、2、4、8h)的血流动力学参数,包括心指数(CI)、全心舒张末容积指数(GEDI)、外周血管阻力指数(SVRI)、血管外肺水指数(EVLWI),并在相同时点监测平均动脉压(MAP)进行前后比较.[结果]与用药前相比较,静脉泵入参附注射液后CI、GEDI、MAP逐渐增加,8h达到最高(P＜0.05).SVRI在用药后逐渐下降,8h达到最低点(P＜0.05),而EVLWI则无明显变化.[结论]参附注射液治疗低排高阻型休克能够明显增加患者心肌收缩力,降低外周循环阻力.%Objective To observe the effect of Shenfu injection on the hemodynamic parameters of low-output and high-resistance shock patients by pulse indicator continuous cardiac output (PiCCO) monitor,and to explore the possible mechanism.Methods The PiCCO was used in 15 patients with low-output and highresistance shock.Continuous intravenous infusion of 10 mL/h Shenfu injection was initiated over 8 hours.The hemodynamic parameters,including cardiac index (CI),global end diastolic index (GEDI),systemic vascular resistance index (SVRI) and extravascular lung water index (EVLWI),were recorded before infusion,and at intervals of 0.5,2,4 and 8 hours of the trial.Meanwhile,mean arterial pressure (MAP)was measured at the same time points.Results Compared with those before treatment,CI,GEDI and MAP were increased while SVRI was decreased gradually (P＜0.05),and they arrived at the peak value at 8 h after administration of Shenfu injection (P＜0.05).EVLWI showed no obvious change.Conclusion Shenfu injection has an effect on increasing myocardial contractility and decreasing peripheral vascular resistance in low-output and high-resistance shock patients.