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[心率变异性在重型颅脑损伤患者预后评估中的价值。1. 实验性临床研究]

[The value of heart frequency variability in the prognostic evaluation of patients with severe cerebral injuries. 1. Experimental clinical studies].

作者信息

Mühlnickel B

机构信息

Klinik für Anästhesiologie und Intensivtherapie, Medizinische Akademie Magdeburg.

出版信息

Anaesthesiol Reanim. 1990;15(6):342-50.

PMID:2083002
Abstract

The heart period duration was measured 201 times for 1,024 heart beats (beat-to-beat intervals) in 96 patients with severe cerebral damage. The standard deviation and the coefficient of the variability was calculated, a Fast-Fourier-Analysis made and the power spectrum represented. The prognostic value of heart rate variability (HRV) and of the power spectrum and their usability for brain death diagnosis were examined. It was shown that: 1st: between patients at the time of a clear clinical deterioration and brain dead patients significant differences existed both in the levels of deviation and in the absolute values of the power spectrum, 2nd: the examined spectral fields were not influenced to the same intensity, 3rd: the decreases of the values of variability and the absolute value of all spectral fields, but especially of the percentage part of the field B, presented a prognostically bad sign and 4th: controlled ventilation also in patients with cerebral areflexia considerably influenced the determined values depending on the breathing volume.

摘要

对96例重症脑损伤患者的1024次心跳(逐搏间期)测量了201次心动周期时长。计算了标准差和变异系数,进行了快速傅里叶分析并呈现了功率谱。研究了心率变异性(HRV)和功率谱的预后价值及其在脑死亡诊断中的可用性。结果表明:第一,在临床明显恶化的患者与脑死亡患者之间,偏差水平和功率谱绝对值均存在显著差异;第二,所检查的频谱域受到的影响强度不同;第三,变异性值和所有频谱域绝对值的降低,尤其是B域百分比部分的降低,呈现出预后不良的迹象;第四,对于脑反射消失的患者,控制通气也会根据呼吸量对所测值产生相当大的影响。

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