摘要
目的探讨心脏术后低心排出量综合征患者体外膜肺氧合(extracorporeal membrane oxygenation,ECMO)辅助支持治疗应用Tei指数监测的价值。方法心脏术后因低心排出量综合征应用ECMO辅助支持治疗患者22例,分别在ECMO建立前、ECMO流量减半时、ECMO撤离后即刻行超声心动图检查测量Tei指数、左室射血分数(left ventricular ejection fraction,LVEF)、左心室舒张末期内径(left ventricular end diastolic dimension,LVEDD)、动脉血氧饱和度(arterial oxygen saturation,SaO_2)、肱动脉收缩压(systolic blood pressure,SBP),Pearson法分析ECMO辅助支持治疗时Tei指数与LVEF的相关性。结果 22例均ECMO撤机成功;ECMO建立前、ECMO流量减半时、ECMO撤离后即刻LVEF[(20.35±1.78)%、(35.45±4.01)%、(38.97±2.31)%]、SaO_2[(82.71±2.67)%、(90.65±1.68)%、(94.38±1.62)%]、肱动脉SBP[(61.27±3.81)、(88.34±3.37)、(97.27±2.19)mm Hg]均逐渐升高,Tei指数(0.72±0.07、0.56±0.02、0.45±0.05)逐渐降低,两两比较差异有统计学意义(P<0.05),不同时间点LVEDD[(55.21±3.23)、(53.87±4.21)、(54.56±7.43)mm]比较差异无统计学意义(P>0.05);Pearson相关分析结果显示,ECMO辅助支持治疗时Tei指数与LVEF呈负相关(r=-0.979,P<0.001)。结论监测Tei指数有助于了解心脏术后低心排出量综合征患者行ECMO辅助支持治疗的疗效,为ECMO撤机提供参考。
Objective To investigate the value of Tel index to monitoring extracorporeal membrane oxygenation （ECMO） support in patients with low cardiac output syndrome after cardiac surgery. Methods Twenty-two patients receiving ECMO support due to low cardiac output after cardiac surgery were detected Tei index, left ventricular ejection fraction （LVEF）, left ventricular end diastolic dimension （LVEDD）, arterial oxygen saturation （SaO2） and systolic blood pressure （SBP） of brachial artery by echocardiography before ECMO, at half flow of ECMO and immediately after ECMO withdrawal. The correlation of Tel index with LVEF was analyzed by Pearson correlation method. Results ECMO was successfully withdrawn in 22 patients. The levels of LVEF （（20.35±1.78）%, （35.45±4.01）%, （38.97±2.31）%）, SaO2 （（82.71±2.67） %, （90.65±1.68） %, （94.38±1.62）%） and SBP of brachial artery （（61.27±3.81）, （88.34± 3.37）, （97.27±2.19） mm Hg） gradually increased, and Tel indexes （0.72±0.07, 0.56±0.02, 0. 45±0. 05） gradually decreased before ECMO, at half flow of ECMO and immediately after ECMO withdrawal, showing a significant difference in multiple comparison （P〈 0.05）. There was no significant difference in LVEDD （（55. 21±3. 23）, （53. 87 ± 4. 21 ）, （54. 56 ± 7. 43） mm） at different time points （P〉0.05）. Pearson correlation analysis showed that Tel index was negatively correlated with LVEF during ECMO support （r= -0. 979, P〈0. 001）. Conclusion Tel index can effectively evaluate the efficacy of ECMO support on low cardiac output syndrome after cardiac surgery, providing a clinical evidence for ECMO withdrawal.
作者
纪淑姣
李玉珍
梁志强
JI Shujiao;LI Yuzhen;LIANG Zhiqiang(Department of Ultrasound,Henan Provincial Chest Hospital,Zhengzhou 450003,China)
出处
《中华实用诊断与治疗杂志》
2018年第9期904-906,共3页
Journal of Chinese Practical Diagnosis and Therapy
基金
河南省医学科技攻关重点项目(201502025)
关键词
低心排出量综合征
体外膜肺氧合
超声心动图
TEI指数
左室射血分数
Low cardiac output syndrome
extracorporeal membrane oxygenation
echocardiography
Tel index
left ventricular ejection fraction
作者简介
通信作者：李玉珍，E-mail：jsj369ccy@126．com。
