摘要
目的探讨脉搏指示连续心输出量监测（PICCO）在大面积脑梗死老年患者液体管理的意义。方法回顾性分析2014年7月至2017年6月入住本院急诊重症监护病房（EICU）的急性大面积脑梗死老年患者48例，按是否使用PICCO分为PICCO组及对照组。对照组根据中心静脉压（CVP）进行液体管理，PICCO组根据PICCO血流动力学数据进行液体管理。比较两组患者治疗前及治疗后1周GCS评分、呼吸机辅助通气时间、ICU住院时间、急性肺水肿发生率和死亡率及治疗1个月后的恢复情况。结果两组患者治疗前格拉斯评分（GCS评分）差异无统计学意义（7．43±2．23VS7．08±2．34，P=0．60），PICCO组治疗后1周GCS评分明显高于对照组（10．13±2．25VS8．04±3．73，P=0．045）；PICCO组的呼吸机辅助通气时间（3．54±0．62VS6．33±0．85，P=0．000）、ICU住院时间（8．00VS10．00，P=0．000）均明显少于对照组，急性肺水肿发生率（8．70％VS36．1％，P=0．039）及死亡率（21．74％VS52．00％，P=0．031）均明显低于对照组。经治疗1个月后，PICCO组的恢复良好率明显高于对照组（56．50％VS28．00％，P=0．000），差异有统计学意义（P〈0．05）。结论PICCO作为血流动力学指标进行液体管理能改善急性脑梗死患者预后。
Objective To observe predictive value of PICCO hemodynamic montoring in fluid man- agement of the elderly patients with massive cerebral infarction. Methods A retrospective analysis of 48 er- derly patients with acute massive cerebral infarction from July 2014 to June 2017 in emergency intensive care unit （EICU） were selected. The patients were divided into the PICCO group and the control groups according to the use of PICCO monitoring. The control group was administered according to the central venous pressure （CVP）, and the PICCO group was administered according to PICCO hemodynamic data. The GCS score be- fore and after 1 weeks treatment, mechanical ventilation time, ICU hospitalization time, the incidence of a- cute pulmonary edema, the mortality and prognosis after 1 month were compared between two groups. Re- suits There was no significant difference in the GCS score of two groups before treatment （7.43±2.23 VS 7.08±2.34, P=0.60） , the GCS score of the PICCO group was significantly higher than that of the control group after 1 weeks treatment （ 10.13±2.25 VS 8.04±3.73, P =0. 045） ; mechanical ventilation time （3.54±0.62 VS 6.33±0. 85, P=0. 000） and ICU hospitalization time （8.00 VS 10. 00, P=0. 000） of PICCO group was significantly less than those in the control group, the incidence of acute pulmonary edema （8.70% VS 36.1%, P =0. 039） and the mortality （ 21.74% VS 52.00%, P =0. 031 ） was significantly less than those in the control group; the prognosis after 1 month of PICCO group was significantly signifi- cantly higher than that of the control group （ 56.50 % VS 28.00%, P = 0. 000）. Conclusions Fluid man-agement through hemodynamic indicators by PICCO can improve the prognosis of acute massive cerebral in- farction.
出处
《实用休克杂志（中英文）》
2017年第2期106-108,117,共4页
Journal of Practical Shock
