摘要
目的:探讨脉波指示剂连续心排血量(Pi CCO)指导下液体复苏在治疗ARDS合并感染性休克老年患者EGDT中的意义,为临床治疗提供指导依据。方法:选用自2013年5月来我院就诊ARDS合并感染性休克老年患者137例作为研究对象,随机分为对照组和治疗组,对照组30例(44.1%),按照常规进行EGDT治疗;治疗组38例(55.9%),采用Pi CCO指导下EGDT治疗。记录两组患者在6h、12h、24h液体复苏情况,分析两组复苏1d后MAP、CVP、Scv O2、Pa O2/Fi O2和血管活性物质状况。并分析6h、12h、24h患者身体状况达标率以及4周后死亡率。结果:治疗组和对照组液体复苏在6h、12h、24h存在显著的统计学差异(t=3.102、3.296、2.853,P<0.05),1d血管活性药物用量治疗组显著低于对照组(t=1.895、4.216,P<0.05),在MAP、CVP、Scv O2、Pa O2/Fi O2上,治疗组要显著高于对照组(P<0.05)。两组之间24h达标率和4周后死亡率存在统计学差异(χ2=11.250、7.071,P<0.05)。结论 :Pi CCO指导下液体复苏对ARDS合并感染性休克老年患者EGDT临床具有良好的疗效,临床值得推广。
Objective： To study the role of the monitoring technology of PiCCO in early goal--directed therapy （EGDT）on the old patients with ARDS and septic shock. Methods： 68 patients with ARDS and septic shock admitted since May 2013 were randomized into 2 groups, 38 cases in the treatment group with PiCCO monitoring indicators for guiding fluid resuscitation and 30 cases in the control group with conventional fluid resuscitation indicators. Then we recorded the results on three time points, 6h, 12h, 24h in these two groups in which MAP, CVP, ScvO2 PaO2/FiO2 and the dosage of the vasoactive substances after 24h were analyzed. At last, we analyze patients＇ health standard rate in 6h, 12h, 24h, and the death rate after 4 weeks. Results：The fluid resuscitation showed significant differences in these two groups in 6h, 12h,24h （t=3.102, 3.296, 2.853, P〈0.05）. In the treatment group, the dosage of the vasoactive substances after 24h was significantly lower than that of the control group （t=1.895,4.216,P〈0.05）, the MAP, CVP, ScvO2, PaO2/FiO2 were significantly higher in the treatment group （P〈 0.05）. There was a significant difference in 24h patient＇s health standard rate and the death rate after 4 weeks （χ2=11.250,7.071,P〈0.05）. Conclusion： Application of PiCCO monitoring technology on EGDT in guidance of fluid resuscitation in the old patients with ARDS and septic shock is of great importance, which is worth of promoting.
出处
《甘肃医药》
2015年第8期561-563,共3页
Gansu Medical Journal
