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目的探讨严重多发伤患者心率变异性(HRV)测定的意义。方法对46例严重多发伤患者于创伤后1、3、7d监测HRV短程频域分析的变化及测定外周血去甲肾上腺素、皮质醇水平(放免法)。设正常对照组10例。结果以损伤严重度评分(ISS)≤16分为分组界限,伤后24h内,各组低频标化功率(LFnm)、高频标化功率(HFnm)、LF/HF明显升高;随后,各组LFnm、HFnm、LF/HF显著降低并低于正常对照组。ISS>16分组的LFnm、HFnm、LF/HF在各个时相点与ISS≤16组相比存在显著性差异(P<0.01)。结论创伤患者HRV发生了显著变化,反映出自主神经功能受损和失衡,并与创伤应激程度密切相关。
Objective To investigate the significance of heart rate variability (HRV) in patients with severe multiple trauma. Methods 46 cases of severe multiple trauma patients at 1, 3, 7 days after trauma were monitored HRV short-range changes in frequency domain analysis and determination of peripheral blood norepinephrine, cortisol levels (radioimmunotherapy). Set the normal control group of 10 cases. Results The score of injury severity (ISS) ≤ 16 was divided into group boundaries. Within 24 hours after injury, the LF-LF, HF-HF and LF / HF were significantly increased in each group. , HFnm, LF / HF were significantly lower and lower than the normal control group. LFnm, HFnm and LF / HF of ISS> 16 group were significantly different from those of ISS≤16 group at each time point (P <0.01). Conclusion The HRV in traumatic patients changed significantly, which reflected the impaired and unbalanced autonomic nerve function and was closely related to the degree of traumatic stress.