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[危重症患者的外周循环:评估外周灌注的非侵入性方法]

[Peripheral circulation in critically ill patients: non-invasive methods for the assessment of the peripheral perfusion].

作者信息

van Genderen Michel E, Lima Alexandre, Bakker Jan, van Bommel Jasper

机构信息

Erasmus MC, afd. Intensive Care Volwassenen, Rotterdam, the Netherlands.

出版信息

Ned Tijdschr Geneeskd. 2013;157(9):A5338.

Abstract

Peripheral tissues, such as skin and muscles, are sensitive to alterations in perfusion. During circulatory shock, these tissues are the first to receive less blood and the last to recover after treatment. By monitoring peripheral circulation, disturbance of the systemic circulation can be detected at an early stage. Peripheral perfusion is often disturbed in critically ill patients. Peripheral perfusion may remain disturbed, even if conventional hemodynamic parameters such as blood pressure and heart frequency normalize after treatment. Persistent abnormal peripheral perfusion is related to a poorer clinical course. With current non-invasive methods, peripheral circulation in critically ill patients can easily be assessed at the bedside. Interventions that improve peripheral circulation may speed up recovery in critically ill patients.

摘要

外周组织,如皮肤和肌肉,对灌注变化敏感。在循环性休克期间,这些组织是最先接受较少血液的,也是治疗后最后恢复的。通过监测外周循环,可以在早期检测到全身循环的紊乱。危重病患者的外周灌注常受到干扰。即使治疗后血压和心率等传统血流动力学参数恢复正常,外周灌注仍可能受到干扰。持续的外周灌注异常与较差的临床病程相关。采用目前的非侵入性方法,可以在床边轻松评估危重病患者的外周循环。改善外周循环的干预措施可能会加速危重病患者的康复。

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