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目的观察多发伤患者心率变异性变化及其临床意义。方法50例多发伤患者分为轻伤和重伤两组。分析伤后第2、9天24h心电图心率变异性。结果伤后第2天轻伤组SDNN(110.25±20.50ms)、SDANN(72.35±28.33ms)、SDNNIndex(51.37±17.37ms)较对照组显著降低(P<0.05),而RMSSD及PNN50与对照组无显著差异(P>0.05)。重伤组SDNN(85.30±30.21ms)、SDANN(68.41±27.52ms)、SDNNIndex(32.77±18.11ms)、RMSSD(20.81±10.31ms)及PNN5(05.41%±2.33%)均显著低于对照组(P<0.05)。伤后第9天,轻伤组与对照组无显著差异(P>0.05);重伤组SDNN(89.91±30.33ms)、SDANN(70.35±29.31ms)、SDNNIndex(43.88±20.31ms)、RMSSD(25.93±12.73ms)及PNN5(05.99%±3.55%)仍然显著低于对照组(P<0.05)。2周内心血管事件发生率重伤组(24.00%)显著高于轻伤组(4.00%)(P<0.05)。结论对多发伤患者作心率变异性检测,有助于了解自主神经功能变化,判断病情发展和预后。
Objective To observe the changes of heart rate variability in patients with multiple trauma and its clinical significance. Methods 50 cases of multiple trauma patients were divided into two groups: minor injury and serious injury. Heart rate variability of ECG on the 2nd and 9th day after injury was analyzed. Results Compared with the control group, SDNN (110.25 ± 20.50ms), SDANN (72.35 ± 28.33ms), SDNNIndex (51.37 ± 17.37ms) were significantly decreased in the mild injury group on the second day after injury (P <0.05) No significant difference (P> 0.05). SDNN (85.30 ± 30.21ms), SDANN (68.41 ± 27.52ms), SDNNIndex (32.77 ± 18.11ms), RMSSD (20.81 ± 10.31ms) and PNN5 (05.41% ± 2.33%) in severe injury group were significantly lower than those in control group <0.05). SDNN (89.91 ± 30.33ms), SDANN (70.35 ± 29.31ms), SDNNIndex (43.88 ± 20.31ms) and RMSSD (25.93) were significantly different between the mild injury group and the control group on the 9th day after injury (P> 0.05) ± 12.73ms) and PNN5 (05.99% ± 3.55%) were still significantly lower than the control group (P <0.05). Within 2 weeks, the incidence of cardiovascular events in severe injury group (24.00%) was significantly higher than that in mild injury group (4.00%) (P <0.05). Conclusions The detection of heart rate variability in patients with multiple trauma can help to understand the changes of autonomic nervous function and judge the progression and prognosis of the patients.