早期PICCO监测在脓毒症急性肾损伤患者治疗中的作用

发布时间：2018-11-19 21:42

【摘要】：目的:探讨脉搏指示连续心排监测(Pi CCO)的早期应用,在合并急性肾损伤(AKI)的脓毒症休克患者治疗中的作用。方法:回顾分析广州医科大学附属第二医院重症医学科收治的合并AKI的脓毒症休克患者75例,按其是否使用Pi CCO监测,分为普通监测组和Pi CCO监测组。观察两组早期液体复苏指标,血管活性药物使用量和肾功能指标。结果:两组患者的平均动脉压(MAP)和心率(HR)比较差异无统计学意义。Pi CCO监测组较普通监测组的总入液量明显减少(P0.05),中心静脉压(CVP)较低(P0.05);且前者的持续肾脏替代治疗(CRRT)时间短,尿量增多,血肌酐水平下降较明显(P0.05)。结论:对合并AKI的脓毒症休克患者进行早期Pi CCO监测,有助于准确指导该类患者的液体管理和帮助肾功能恢复。
[Abstract]:Objective: to investigate the early application of pulse indicator continuous cardiac output monitoring (Pi CCO) in the treatment of septic shock patients with acute renal injury (AKI). Methods: a total of 75 patients with septic shock complicated with AKI in the Department of intensive Medicine, second affiliated Hospital of Guangzhou Medical University were retrospectively analyzed. According to whether they were monitored by Pi CCO, they were divided into two groups: general monitoring group and Pi CCO monitoring group. The indexes of early fluid resuscitation, dosage of vasoactive drugs and renal function were observed. Results: there was no significant difference in mean arterial pressure (MAP) and heart rate (HR) between the two groups. The total fluid volume in the. Pi CCO monitoring group was significantly lower than that in the general monitoring group (P0.05), and the central venous pressure (CVP) was lower (P0.05). In the former group, the duration of (CRRT) was short, the urine volume was increased, and the serum creatinine level was decreased significantly (P0.05). Conclusion: the early monitoring of Pi CCO in septic shock patients with AKI is helpful to guide the fluid management and to help the recovery of renal function.
【作者单位】：广州医科大学附属第二医院重症医学科;广东省开平市中心医院急诊科;
【基金】：广东省自然科学基金项目(编号:S2013010014887)
【分类号】：R459.7

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