有创血压监测在严重烧伤病人休克期液体复苏中的初步应用

目的 :为实施烧伤休克期液体复苏多指标监测 ,在无创血压 (none invasivebloodpressure ,NIBP)无法监测时 ,创造条件进行有创血压 (invasivebloodpressure ,IBP)监测 ,并观察其临床应用的可行性及实用价值。方法 :选择 12例特重、4例重度烧伤病人桡动脉 6次、足背动脉 12次、股动脉 2次、肱动脉 1次 ,应用聚四氟乙烯套管针进行动脉穿刺 ,通过充满肝素盐水的专用测压管道与监护仪相连进行测压。通过观察动脉搏动波形及血压数值 ,对病人血压实行动态监护 ,并与同体无创血压对比。结果 :有创血压的实施克服了无创压监测的不足 ,使对肢体严重烧伤的病人监测成为可能 ,且可连续监测血压数值及变化。一般来说 ,IBP较NIBP高 5～ 2 0mmHg ,但与无创压的变化同步 ,相关性较好。结论 :有创动脉压监测因可显示动脉波形和数值的动态变化 ,能及时发现病人的病情变化 ,灵敏度大于无创压监测 ,在严重烧伤病人监测中具有重要的意义 ,具有广阔的前景

The initial application of invasive blood pressure monitoring in fluid resuscitation of severe burn patients in shock period

Objective: To evaluate the feasibility and clinical value of invasive blood pressure monitoring in fluid resuscitation of severe burn patients in shock period. Methods: 12 patients with very severe burn and 4 with severe burn were enrolled in this study, whose radial artery ( 6 cases ), dorsal artery of foot ( 12 cases ), femoral artery ( 2 cases ) and brachial artery ( 1 cases ) were successfully punctured by Teflon cannula needle. Blood pressure was continuously measured through the specific pipeline flushed with hepalean saline, which was connected to the monitor. Continuously invasive blood pressure values was recorded by both artery pulse wave form and blood pressure value and simultaneously compared with non-invasive blood pressure values. Results: It is feasible to invasively monitor the blood pressure of patients with severe burn on limb. In general, the blood pressure values measured invasively were higher 5～20?mmHg than those non-invasively, but those changes were synchronizated. There was good correlation between them. Conclusion: Invasive blood pressure monitoring may be extensively used in clinical practise because it can show the development change of artery pulse wave form and blood pressure numerical value. Its sensitivity is higher than non-invasive blood pressure's.