[化脓性腹膜炎患者滤过解毒过程中的心肌储备]。

Sovetskaia meditsina Pub Date : 1991-01-01
A V Vatazin, N Iu Machulina, E G Karpova
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引用次数: 0

摘要

对36例弥漫性化脓性腹膜炎患者进行滤过解毒试验,探讨体外循环模拟功能负荷下心肌功能储备测定的可行性。在四极流变仪的控制下,共进行了49次血液过滤和过滤交换血浆置换。研究表明,在体外解毒过程中,收缩量和心输出量的持续下降、中央血容量的增加以及对心肌负荷前后的病理阻抗波的反应可能是亚临床心肌衰竭的指示。检测到心肌储备减少提示限制血浆置换和输注治疗中的血液稀释或滤过后期的lasix给药。
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[Myocardial reserve during filtration detoxification in patients with suppurative peritonitis].

Feasibility of measuring functional reserve of the myocardium under functional loads simulated by extracorporeal circulation was tried in 36 patients with diffuse purulent peritonitis on filtration detoxication. Altogether 49 sessions of hemofiltration and filtration exchange plasmapheresis were performed controlled by tetrapolar rheography. It is demonstrated that persistent decline of systolic and cardiac output, an increase of central blood volume and occurrence of a pathological impedance wave in response to pre- and postload on the myocardium during extracorporeal detoxication may serve an indication of a subclinical myocardial failure. Detection of a reduced myocardial reserve suggests restriction of hemodilution in plasmapheresis and infusion therapy or lasix administration in postfiltration period.

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