摘要
目的探讨脉搏指示连续心排血量监测(PiCCO)在脓毒性休克患者早期液体复苏及治疗中的临床应用价值。方法选取2013年7月至2015年5月本院收治的符合入选标准的50例脓毒性休克患者,按随机数字表法分为研究组和对照组各25例。研究组患者于PiCCO指导下进行液体复苏及治疗,对照组患者利用中心静脉压(CVP)指导液体复苏及治疗。观察两组患者治疗前后的急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ评分)、血乳酸清除率、复苏液体量、CVP、尿量、平均动脉压、呼吸机使用例数、肺水肿及心衰发生例数。结果经过液体复苏及治疗后两组患者的APACHEⅡ评分均逐步下降,72h时研究组明显低于对照组,差异有统计学意义(P<0.05);6、24h时研究组液体使用量明显多于对照组,而72h时液体总量明显少于对照组,差异均有统计学意义(P<0.05);治疗6、24h后研究组乳酸清除率、尿量、CVP、平均动脉压均优于对照组,差异均有统计学意义(P<0.05);72h时研究组发生心衰及肺水肿的例数明显少于对照组,差异均有统计学意义(P<0.05)。72h后两组患者使用呼吸机例数比较差异无统计学意义(P>0.05)。结论 PiCCO监测可较为准确地评估脓毒性休克患者的容量状态,精准地指导液体复苏及治疗,减少并发症,对脓毒性休克患者早期液体复苏及治疗具有较好的指导意义。
Objective To explore the clinical application value of the pulse indicated continuous cardiac output（PiCCO）monitoring in early fluid resuscitation and treatment of septic shock patients.Methods 50 patients with septic shock conforming to the inclusion criteria in our hospital from June 2013 to May 2015 were selected and randomly divided into the study group and the control group according to the random number table method,25 cases in each group.The study group was performed the fluid resuscitation and treatment under the guidance of PiCCO,while the fluid resuscitation and treatment in the control group was guided by the central venous pressure（CVP）.The scores of acute physiology and chronic health evaluation system Ⅱ（APACHE Ⅱ）before and after treatment,blood lactate clearance rate,liquid quantity of resuscitation,CVP,urine volume,MAP,number of cases needing the mechanical ventilation and cases of pulmonary edema and heart failure were observed in the two groups.Results The APACHEⅡ scores after fluid resuscitation and treatment in the two groups were significantly decreased,which at 72 h in the study group were significantly lower than that in the control group with statistical difference（P〈0.05）.The fluid use amounts at 6,24 hin the study group were significantly more than those in the control group,but the fluid total amounts at 72 hwere significantly less than those in the control group,the difference was statistically significant（P〈0.05）;the lactate clearance rate,CVP,urine volume and MAP at 6,24 hof treatment in the study group were superior to those in the control group,the differences were statistically significant（P〈0.05）.The number of cases of lung edema and heart failure occurrence at 72 hin the study group was significantly less than that in the control group with statistical difference（P〈0.05）.No statistically significant difference in the cases number of using mechanical ventilation was found between the two groups（P〉0.05）.Conclusion The PiCCO monitoring
出处
《检验医学与临床》
CAS
2016年第5期619-622,共4页
Laboratory Medicine and Clinic
基金
2013年重庆市第六批科技计划项目(cstc2013jcsf10026)
