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目的应用阻抗心动描记法(ICG)监测感染性休克患者血流动力学参数,探讨心功能不全对感染性休克预后的影响。方法选择住院治疗的感染性休克患者75例,应用ICG进行血流动力学监测,比较初始及24 h心功能指标;患者按住院28 d转归情况分为存活组35例和死亡组40例,比较2组心功能指标;将患者分为高心输出量组(CO>4 L/min)和低心输出量组(CO≤4 L/min),比较2组患者死亡率。结果感染性休克患者治疗后24 h,心输出量、心脏指数、每搏量、心搏指数较治疗前升高,差异有统计学意义(P<0.05);外周血管阻力、外周血管阻力指数、心率较治疗前降低,差异有统计学意义(P<0.05);死亡组心输出量、心脏指数、每搏量、心搏指数、左心室射血分数、加速指数低于存活组,心率高于存活组,差异有统计学意义(P<0.05)。低心输出量组病死率高于高心输出量组,差异有统计学意义(P<0.05)。结论 ICG监测可反映感染性休克患者心功能状态,心功能不全导致感染性休克患者病死率增加。
Objective To monitor the hemodynamic parameters of septic shock patients by impedance echocardiography (ICG) and investigate the influence of cardiac insufficiency on the prognosis of septic shock. Methods Seventy-five patients with septic shock were enrolled in this study. ICG was used for hemodynamic monitoring. Initial and 24-h cardiac function were compared. The patients were divided into survivor group (n = 35) and death group (n = 40) The patients were divided into high cardiac output group (CO> 4 L / min) and low cardiac output group (CO≤4 L / min) to compare the mortality of the two groups. Results After 24 h of treatment, the cardiac output, heart index, stroke volume and heart rate index increased significantly after treatment (P <0.05). The peripheral vascular resistance, peripheral vascular resistance index, Heart rate, heart rate, stroke volume, cardiac index, left ventricular ejection fraction, acceleration index lower than the survival group, heart rate was higher than that of the survival group Survival group, the difference was statistically significant (P <0.05). The mortality of low cardiac output group was higher than that of high cardiac output group, the difference was statistically significant (P <0.05). Conclusion ICG monitoring can reflect the state of cardiac function in patients with septic shock. Cardiac insufficiency leads to increased mortality in patients with septic shock.