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題 名 | Hemodynamics Determined by Swan-Ganz Catheter in Patients with Septic Shock=利用Swan-Ganz導管對敗血症休克病人血行變化之測定 |
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作 者 | 黃燦龍; 陳敏夫; 沈菁華; | 書刊名 | 中華民國外科醫學會雜誌 |
卷 期 | 25:6 民81.11-12 |
頁 次 | 頁1413-1417 |
分類號 | 415.27 |
關鍵詞 | Swan-Ganz導管; 敗血症休克; 血行變化; |
語 文 | 英文(English) |
中文摘要 | 我們利用Swan-Ganz導管,對七位嚴重敗血症的病人測定其詳細的血行變化,以作為治療的參考。這些病人的敗血症指數為41至75不等。當病人的Swan-Ganz導管建立後,我們以熱稀釋法測量其心輸量,再算出其心輸量指數、周邊及肺部血管抗性、左右心室搏動指數等值。七位病人中有三位病人呈現出低心輸指數及高周邊血管抗性,他們對所有昇壓劑的給予,均無反應而終於死亡。另外一位病人則呈現高心輸指數及低周邊血管抗性,但也因對昇壓劑反應無效而死亡。存活下來的三位病人,其中兩位呈現高肺部血管抗性,於使用血管擴張劑後反應良好,情況改善而存活。因此對於複雜的敗血症休克病人,如果初期治療效果不好時,建立Swan-Ganz導管,分析其血行變化,將是有所裨益的。 |
英文摘要 | Detailed hemodynamic data were studied for seven patients with severe septic shock resulting from various etiologies. Each had received strong antibiotics and vasopressor agents. Their septic severity scores ranged from 41 to 75. A Swan-Ganz catheter was used to measure cardiac output with thermodilutional methods. Cardiac index, systemic and pulmonary vascular resistance and left and right ventricular stroke index were determined. Three patients, all with low cardiac indices and high systemic vascular resistance, expired without response to vigorous treatment with catecholamines. One patient who had a high cardiac index but very low systemic vascular resistance also expired, despite the use of strong vasopressor agents. Three patients survived; two had a good response to vasodilators for high pulmonary vascular resistance. Swan-Ganz catheterization is helpful in patients with complicated septic shock with poor response to primary treatment, especially if there is associated heart disease. Adequate treatment of septic shock depends on informed judgement based on detailed hemodynamic data. |
本系統中英文摘要資訊取自各篇刊載內容。