血流动力学监测进展.ppt

血流动力学监测进展;History of Monitoring;;一、无创血流动力学监测;（一）心阻抗血流图;Figure１: Application of electrodes in impedance cardiography ;Figure 7: Variation of ventricular, aortic and atrial pressure, aortic flow, thoracic impedance change and fist derivative of impedance (dz/dt) as a function of time (t). ECG and phonocardiogram taken simultaneously is also shown. 　　The curve depicts the cardiac events / performance. B – Opening of the Aortic Valve, X – Closure of the Aortic Valve, Y – closure of pulmonary valve, O – mitral valve opening/rapid ventricular filling, B-X – Ventricular Ejection Time (VET), C – Maximal deflection of dz/dt (Peak Flow), B-C slope – Acceleration Contractility Index, A – Atrial Systole, Q – Start of ventricular depolarization;Philips Impedance Cardiography (ICG) continuously measures hemodynamic parameters without the associated risks of traditional invasive methods. ? The Philips ICG measurement is ideal for hemodynamic evaluation of adult patients in: 　Emergency departments 　Step-down units 　Special procedure ;Using ICG for the appropriate patient populationThe ICG measurement is designed for assessment of most adult patients – height 122-229 cm (4′-7′6?) and weight 30-159 kg (67-350 lb) – but may demonstrate reduced accuracy when patients present with the following conditions or anomalies:;ICG是一项无创伤性的方法，操作简单、费用低、安全。可动态连续监测CO及与其有关的血流动力学参数，最新研制的阻抗血流图仪能显示和打印16个测定和计算参数及心功能诊断和治疗图。 ICG 由于其抗干扰能力差, 易受病人呼吸、心律失常及手术操作等的干扰, 尤其是不能鉴别异常结果是由于病人的病情变化引起, 还是由于机器本身的因素所致,其绝对值有时变化较大, 故在一定程度上限制了其在临床上的广泛使用。;（二）超声心动图;Echocardiography: Seeing with Sound;Echocardiogram ;EchocardiogramAn echocardiogram is a test in which ultrasound is used to examine the heart.;Echocardiograms can evaluate: the presence of any abnormal fluid collection in the sac around the heart (pericardium). the chamber size, thickness of the heart muscle wall and how well it is functioning. the function of the heart valves - whether they are obstructing blood flow or leaking. any abnormal connection