摘要
目的探讨脉搏轮廓心排血量(PICCO)监测技术在大面积烧伤患者休克期液体复苏中的应用。方法选择2015年1月至2018年7月收治的30例大面积烧伤患者作为研究对象,根据监测方法将其分为PICCO监测组15例与常规监测组15例。两组患者均采用相同的治疗方法,其中常规监测组在生命体征监测、尿量的指导下进行液体复苏。PICCO监测组在此基础上采用PICCO技术监测患者血流动力学。统计两组患者的第1、2个24 h晶体、胶体、总输液量、尿量,伤后24、48、72 h乳酸值、剩余碱,统计两组患者ICU天数、机械通气时间、病死率情况。结果PICCO监测组伤后第1个24 h胶体[(3392.86±1186.12)ml比(4850.00±1498.97)ml]及第1个24 h总输液量[(8498.15±3278.31)ml比(12340±3500.97)ml]均明显少于常规监测组(均P<0.05),而两组患者伤后第2个24 h总输液量、第1个24 h尿量、第2个24 h尿量比较差异均无统计学意义(均P>0.05);PICCO监测组伤后24 h的乳酸值[(5.01±1.61)mmol/L比(6.66±1.82)mmol/L]、剩余碱值[(0.81±5.45)mmol/L比(-3.69±3.05)mmol/L]均较常规监测组低(均P<0.05),其余时间点两组患者乳酸值、剩余碱值相近(均P>0.05);两组患者住ICU天数、机械通气时间、病死率比较差异均无统计学意义(均P>0.05)。结论采用常规监测方法指导液体复苏可使患者平稳度过休克期,辅以PICCO技术进行监测,有效避免过度液体复苏造成的肺水肿,有利于提高生命体征稳定性。
Objective To investigate the application effect of pulse index continuous cardiac output(PICCO)monitoring technology in fluid resuscitation of patients with extensive burn in shock stage.Methods The clinical data of 30 patients with extensive burn hospitalized in our hospital from January 2015 to July 2018 were retrospectively analyzed.The patients were divided into traditional monitoring group(n=15)and PICCO monitoring group(n=15)according to the monitoring technology during fluid resuscitation.The input volumes of electrolyte,colloids,the fluid infusion volume,urine volume of patients in the two groups within the first,second 24 hours post injury were recorded.The blood lactate,base excess of patients in the two groups at 24,48,72 hours post injury were recorded.ICU days,mechanical ventilation time,and mortality were compared between the two groups.Results The input volumes of colloid and the fluid infusion volume of patients in PICCO monitoring group were significantly less than those in the traditional monitoring group within the first 24 hours post injury[(3392.86±1186.12)ml vs.(4850.00±1498.97)ml,(8498.15±3278.31)ml vs.(12340±3500.97)ml](all P<0.05).There were no statistically significant differences in the total amount of fluid infusion within the second 24 hours post injury,urine volume within the first,second 24 hours post injury between the two groups(all P>0.05).The levels of blood lactate,base excess of patients of the PICCO monitoring group were lower than those of the traditional monitoring group at 24 hours post injury[(5.01±1.61)mmol/L vs.(6.66±1.82)mmol/L,(0.81±5.45)mmol/L vs.(-3.69±3.05)mmol/L](all P<0.05);the levels of blood lactate and base excess of patients of the two groups were similar at the other time points(all P>0.05).There were no statistically significant differences in ICU days,mechanical ventilation time,and mortality between the two groups(all P>0.05).Conclusion Based on the traditional burn shock monitoring indicators,the use of PICCO monitoring technology for large-area
作者
陈丽映
余惠
朱飘飘
祝芳芳
秦金莲
李孝建
Chen Liying;Yu Hui;Zhu Piaopiao;Zhu Fangfang;Qin Jinlian;Li Xiaojian(Department of Burn and Plastic Surgery,Guangzhou Red Cross Hospital,Guangzhou 510220,China)
出处
《国际医药卫生导报》
2020年第13期1842-1845,共4页
International Medicine and Health Guidance News
基金
广州市卫生计生科技一般引导项目(20171A010260)
广州市高水平临床重点专科建设资助项目。
关键词
脉搏轮廓心排血量监测技术
烧伤
休克期
液体复苏
Pulse index continuous cardiac output(PICCO)monitoring technology
Burn
Shock stage
Fluid resuscitation
