中文摘要：

【目的】探讨伴有中重度低钠血症的休克患者脉搏指数连续心输出量（PiCCO）监测的血流动力学特点。【方法】对19例伴有中重度低钠血症的休克患者的临床资料进行回顾性分析，根据预后分为存活组11例、死亡组8例，比较PiCCO连续监测记录每例置管期间的血流动力学参数，记录每例置管期间每日液体平衡（W），分析PiCCO监测的血流动力学特点及影响患者预后的危险因素。【结果】两组患者置管时血流动力学类型多为低排高阻型、血管外肺水指数（EVI。WI）高，置管期间w与EVLWI的变化值（△EVI。wI）及全心舒张末期容积指数的变化（△GEDI）相关性显著。两组置管第3天死亡组的EVI，WI明显高于生存组的EVLwI（P〈0．01）。【结论】对于伴有中重度低钠血症的休克病人，PiCCO监测的全心舒张末期容积指数（GEDD较中心静脉压更适合反映伴有中重度低钠血症的休克患者的容量状态，EVLwI的动态变化可以作为伴有中重度低钠血症体克患者预后的独立预测指标。

英文摘要：

[Objective] To explore the hemodynamic characteristics of pulse-indicated continuous cardiac output（PiCCO） monitoring for shock patients with moderate to severe hyponatremia. [Methods] The clinical data of shock patients with moderate to severe hyponatremia were analyzed retrospectively. According to the prognosis, all patients were divided into survival group（ n =11） and death group（ n =8）. PiCCO continuous monitoring was used to record the hemodynamic parameters and daily fluid balance volume（W） of every pa tients during intubation. The hemodynamic characteristics monitored by PiCCO and the risk factors influencing the prognosis of the patients were analyzed. [Results] When intubation, most of the hemodynamic types of the patients in two groups were the type of low cardiac output and high vascular resistance, and the extravascular lung water index（EVLWI） was high. During intubation, the W was significantly correlated with lhe change of EVLWI（△EVLWI）. and global end-diastolic volume index（△GEDI）. On the third day of intubation, EVLWl in death group was significantly higher than that in survival group（ P〈0.01）. [Conclusion] The （GEDI moni tored by PiCCO is more suitable for assessing the volume status of shock patients with moderate to severe hyponatremia than central venous pressure（CVP）. The dynamic change of EVLWI is an independent prognostic factor for shock patients with moderate to severe hyponatremia.