论文部分内容阅读
目的:通过单指示剂跨肺热稀释技术(Pi CCO)监测,探讨不同剂量甘露醇对颅脑损伤患者心肺功能及脱水作用的影响。方法:选取颅脑损伤患者20例,行Pi CCO监测。患者随机分为两组,给予20%甘露醇Ⅰ组125 ml、Ⅱ组250 ml。测量给甘露醇之前(T0)及给甘露醇后30 min(T1)、1 h(T2)、2 h(T3)、3 h(T4)时患者的各项生命体征及Pi CCO数值。结果:Ⅱ组组内各时间点与T0比较,全身血管阻力指数(SVRI)在T1时显著低于T0(P<0.05),全心射血分数、心功能指数在T1时显著高于T0(P<0.05)。两组尿量比较,在T2及T3时Ⅱ组显著高于Ⅰ组(P<0.05)。Pi CCO值比较,SVRI在T2及T4时Ⅱ组显著高于Ⅰ组(P<0.05),左室收缩力指数在T0、T2、T3及T4时Ⅱ组低于Ⅰ组(P<0.05)。结论:大剂量甘露醇可以显著增加心脏做功;大剂量甘露醇利尿作用强于小剂量甘露醇;对原有基础心脏疾病的颅脑损伤患者,使用小剂量甘露醇安全性更高。
OBJECTIVE: To investigate the effects of different doses of mannitol on cardiopulmonary function and dehydration in patients with craniocerebral injury by single-indicator trans-pulmonary thermodilution (Pi CCO). Methods: Twenty patients with craniocerebral injury were selected and monitored by Pi CCO. Patients were randomly divided into two groups, giving 20% mannitol group Ⅰ 125 ml, Ⅱ group 250 ml. The vital signs and Pi CCO values were measured before (T0) mannitol and 30 min (T1), 1 h (T2), 2 h (T3), 3 h (T4) Results: Compared with T0, SVRI in T1 group was significantly lower than that in T0 group (P <0.05) at all time points in group Ⅱ, and the whole heart ejection fraction and cardiac function index at T1 were significantly higher than those at T0 P <0.05). The urinary output of the two groups was significantly higher in group Ⅱ at T2 and T3 than that in group Ⅰ (P <0.05). The Pi CCO value of SVRI at T2 and T4 was significantly higher in group Ⅱ than that in group Ⅰ (P <0.05). The index of left ventricular contractility was lower in group Ⅱ than that of group Ⅰ at T0, T2, T3 and T4 (P <0.05). Conclusion: High-dose mannitol can significantly increase cardiac work; high-dose mannitol diuretic effect is stronger than low-dose mannitol; the original basic heart disease in patients with craniocerebral injury, the use of small doses of mannitol more safe.