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目的初步探讨检测分析副交感神经系统(PNS)活性在评价重症监护患者整体功能状况中的应用。方法将23例重症监护患者(男15例、女8例,年龄21～83岁)分为手术组(12例)和非手术组(11例)。使用Holter心电图仪进行连续心电监测,将所获R-R间隔的时间序列资料以10min为一个单位进行分隔,采用粗视化频谱分析连续对所有分隔序列进行PNS活性分析。结果手术组患者PNS活性较强而非手术组患者PNS活性较弱。非手术组患者PNS活性在病情好转后回升。手术组患者在手术当日PNS活性较强,但术后1～2dPNS活性降至较低水平。所有患者随着病情稳定和恢复,PNS活性逐渐回升。结论 PNS活性分析可用于评价重症患者整体功能状态及其预后。
Objective To explore the application of detecting and analyzing the activity of parasympathetic nervous system (PNS) in evaluating the overall functional status of intensive care patients. Methods Twenty-three intensive care patients (15 males and 8 females, aged 21-83 years) were divided into operation group (n = 12) and non-operation group (n = 11). The Holter electrocardiograph was used for continuous ECG monitoring. The time-series data of R-R intervals were separated by 10min units. PNS activity analysis was continuously performed on all the separated sequences by using the gross spectrum analysis. Results The patients in operation group had stronger PNS activity than those in operation group. PNS activity in non-surgical patients rose after the condition improved. The patients in operation group had stronger PNS activity on the day of operation, but the activity of PNS decreased to the lower level 1-2 days after operation. PNS activity gradually rose in all patients as the disease stabilized and recovered. Conclusion PNS activity analysis can be used to evaluate the overall functional status and prognosis of critically ill patients.